Records Request Form

Should you need your records sent to another provider, please download and complete the form below and return it to our office. Please allow at least one business week for the request to be completed. If you have any questions or need the process to be expedited, please call our office and speak to a staff member.

Please note: There is an associated fee of 15¢ per page to have your records printed for you. There is no charge if they are sent directly to another provider or if they are sent to you electronically.