To request medical records, please fill out the Authorization Of Medical Records Release.  
In order for us to process your request, we will require an upfront fee.  Pages 1-25 is .50 per page; 26-50 is .30 per page; 51-75 is .20 per page (plus applicable charges for postage)

Step 1      Download and Fill out this form  Authorization of Medical Records Release
Step 2      Upon receipt of your request, we will send to you a Billing Statement for Copies of Medical Records
                 Once payment has been made, we will process your request.
                 We accept all major credit cards and checks.  Please do not pay with cash. 
                 Payments can be made on our website payment platform at

For Release of X-Ray Records 
Download and Fill out this form  Release of X-Ray Records