Quick Release to You New Medical Records Request

Patient Information

Please select the visits/admissions you would like released:
Please select the type of information you would like released:

Purpose of Request

Please enter your reason for requesting records.

Your Information

Delivery Information

Medical Records Delivery Options

Please choose from one of the below options for Medical Records. You can download them directly from the website, or have them created on CD to be delivered by mail via the US Postal Service to the address entered below, or Picked up at the Medical Facility.

Delivery Summary

  • Normal processing time is 5 business days from time of receipt.
  • Please contact us if you have any questions.
Cancel