Transfering Medical Records - Existing Patients

To transfer records from our office to other healthcare providers:

• Sign a record release form. Front desk staff will provide requested records directly after form has been completed and signed.
• ANY PATIENT ABOVE THE AGE OF 18 WILL BE REQUIRED TO SIGN THEIR OWN RECORD RELEASE FORM.

***If you have received a physical, immunization, or other type of care outside of our practice, please be sure to transfer those records to our office. As your primary care physicians, it is crucial that we have all records pertaining to our patients in order to fill the gap and deliver the best care possible.***

Record Release Form

• Print and complete the record release form online or in person at any of our office locations.
• Upon completion and submission of form, medical records will be outsourced to a medical copy service who will then print out records in entirety and delivered to address specified on the form. (Note: There is a small fee of a maximum of $25, depending on the size of the chart. This will be billed directly from the copy service, and not our office.)
• Please allow 2-3 weeks from submission of record release form.
• ANY PATIENT ABOVE THE AGE OF 18 WILL BE REQUIRED TO SIGN THEIR OWN RECORD RELEASE FORM.

***If you have received a physical, immunization, or other type of care outside of our practice, please be sure to transfer those records to our office. As your primary care physicians, it is crucial that we have all records pertaining to our patients in order to fill the gap and deliver the best care possible.***

Record Release Form