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(step 1:) Please fill out the Medical Records Release Form
(step 2:) Place order for records
$25.00
Select whether you would like to receive Medical Records for 1 individual or multiple individuals in the family. A single $25 copy fee applies if all household members’ records are sent to one recipient. You can add notes at checkout with additional information. Please list the names and date of birth of each individual patient in the family requiring records.