To request medical records, please complete the following steps:
- Complete the proper authorization form to release the records. Download the “Authorization to Release and Receive Confidential Information” pdf here.
- Fill out the form fully and correctly. An incomplete form will delay the process. The more specific their request, the faster the records will be produced. Please check the specific items you want released and be sure to explain the purpose of this record request so we can best assist you. • Please see the instructions below for filling out the ROI. Instructions are also included with the downloaded PDF.
- Email or Fax the completed “Authorization to Release and Receive Confidential Information” form to the Medical Records Department at the email address or fax number below.
- Email: [email protected]
- Fax: (424) 285-8154
- The client must sign the authorization for the release of records. This is in accordance with state laws and industry standards.
- Session notes are not released, per state laws and confidentiality practices.
- The turnaround time is 2 weeks for the records to be sent via encrypted email or faxed.
Instructions for Completing the Release of Information (ROI)