Records Request Form

Please complete the records request form below. If you are requesting any medical records, you will also need to fill out the Medical Release form below and upload it with your request.

Your request will be responded to within five days after receiving the payment.

There is a $20 fee for records requests with an additional $50 for photographs if they are also available. That fee is required before we can proceed with the request. (Payment by check or money order only.) We will also charge a cost recovery hourly rate plus $0.50 per page along with a shipping and handling fee that will be invoiced prior to the records being distributed.