Medical Records

Looking to obtain a copy of your medical records?

Paper copy of medical records:

Please complete the following steps to obtain a paper copy of your medical records:

1. Print and complete the Medical Records Release Form.
2. Complete, sign and date the form. In order to verify your identification and validate your authorization, we require that you include a legible copy of a valid photo I.D. (e.g., driver’s license, military I.D. or state I.D.).
3. Mail or fax your paperwork to the mailing address or fax number below.

For questions regarding obtaining medical record copies, or to obtain the status of your request:

• Phone: (866) 270-2311

Records will be shipped within 5-7 Business days. Should you need to check the status of your request, please call (866) 270-2311

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Urgent requests, records for your physician

For immediate continuity of care, your healthcare provider can request records.

The physician office must fax a written request on their letterhead to (877) 865-9738 indicating the patient's name, date of birth, date of visit in the facility, facility Name and place "STAT" at the top of their request. For assistance call (866) 270-2311.

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Insurance, attorney, disability and third party requests

Requests should be sent from your insurance company, attorney, or Disability Determination Service can be faxed to (855) 901-6104 or mailed to the facility where the patient was treated.

Looking to obtain a copy of your medical records?

Paper copy of medical records:

Please complete the following steps to obtain a paper copy of your medical records:

1. Print and complete the Medical Records Release Form.
2. Complete, sign and date the form. In order to verify your identification and validate your authorization, we require that you include a legible copy of a valid photo I.D. (e.g., driver’s license, military I.D. or state I.D.).
3. Mail or fax your paperwork to the mailing address or fax number below.

For questions regarding obtaining medical record copies, or to obtain the status of your request:

• Phone: (866) 270-2311

Records will be shipped within 5-7 Business days. Should you need to check the status of your request, please call (866) 270-2311

---

Urgent requests, records for your physician

For immediate continuity of care, your healthcare provider can request records.

The physician office must fax a written request on their letterhead to (877) 865-9738 indicating the patient's name, date of birth, date of visit in the facility, facility Name and place "STAT" at the top of their request. For assistance, call (866) 270-2311.

---

Insurance, attorney, disability and third party requests

Requests should be sent from your insurance company, attorney, or Disability Determination Service can be faxed to (855) 901-6104 or mailed to the facility where the patient was treated.