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New Medical Records Request

Patient Information

Please enter the date range for the visits/admissions you would like released:
Please select the type of information you would like released:
Medical Records
Itemized Billing for the dates of service I specified above
Radiology/Imaging CD for the dates of service I specified above

Purpose of Request

Please enter your reason for requesting records.

Your Information

Medical and Billing Records Delivery

Optionally, you may also request to pick up records at the hospital. They will still be available online.

Normal processing time is 48 hours from time of receipt of your order or 2 business days for radiology/imaging CDs. Please contact us if you have any questions.

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