Medical Release Forms

Medical Release Information

We have partnered with MediCopy to fulfill your Release of Information requests. MediCopy is fully HIPAA compliant and adheres to all state and federal regulations concerning release of medical information.

Patients can request copies of their medical records at no cost, but delivery fees apply for postage! Please provide an email address on the authorization to expedite the process and delivery method. Records sent via email or to another provider are complimentary. Requests are completed within two (2) business days after receipt by MediCopy.

To request your medical records please fill out one of the following authorization forms:

If you have any questions, please contact MediCopy:

Online Chat: MediCopy.net | Phone: 866-587-6274 | Email: [email protected]

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