Obtaining a copy of your medical record is easy. To start your request, simply download, print, complete, and sign the Authorization to Release Medical Information Form provided below. Fax, mail, or email it back to us, to the attention of Medical Records.

Unsigned requests cannot be processed and failure to provide all information may invalidate the request.

Your request will be processed and fulfilled within 15 business days from the day it is received. Please allow reasonable time to process your request. We will mail your records to the address specified on the authorization form.