If you are transferring to our practice, or transferring away from our practice, you will need to transfer your records from/to the other provider. Please complete the appropriate form below to give us permission to receive or send your medical records.
You may fill out the form on your computer and print out the finished result. Or, you can print the blank form and fill in the fields by hand. In either case, you will need to return the completed form to our office by mail, fax, or hand delivery.