Medical Records Release

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Your medical records are confidential and will remain on file under our custodianship according to state and federal statues. Please note, by law we cannot share your medical information without your written consent. You will need to sign an authorization form before we can release your medical records or you may complete the necessary paperwork at your first visit with your new doctor and email to amarasco@hotmail.com. The time for retrieval of records depends on the age and extent of the medical record. If you are requesting medical notes for continuity of care with a new provider inquire as to the extent of the record required as some providers are only in need of the most recent notes. 

Instructions for Request of Medical Records and completion of Patient Authorization Form for Medical Records Release 

 

  1. Submit the following Request For Release of Medical Records.  

  2. Open Patient Authorization for Release of Medical Records. Complete, sign and date.  Send the completed form to amarasco@hotmail.com for processing.  

1. Request for Release of Medical Records

Your Request Has Been Submitted For Processing

2. Patient Authorization For Release of Medical Records         Open >