Request your medical records

We log your request the moment you send it and respond within the time the law requires. It takes about four minutes — you will sign at the end.

Who is asking

What would you like to do?

Get copies of my recordsInspect / view my records

Your relationship to the patient

The patient

First name

Last name

Date of birth We use this to find the right chart. Two of our patients often share a name.

Mobile number

Give us at least one of these so we can reach you.

What you need

Which records

From (optional)

To (optional)

How you want them, and what it costs

How would you like to receive them?

Electronic copySent securely to your email.No chargePaper copy, mailedPrinted and posted to you.$0.25 a pagePaper copy, collectedReady at the office you choose.$0.25 a pagePaper copyWe will agree how to get it to you.$0.25 a pageNo preferenceWe will pick whichever is quickest.—

Send these records to someone else — another doctor, a family member, an attorney — instead of to me.

Your signature

By typing my name below I am signing this request electronically. I confirm that I am the patient or the patient's authorized personal representative, that the information I have given is accurate, and that my typed name is my signature and has the same effect as signing on paper. I understand my identity may be verified before any records are released.

Type your full name to sign

I agree that my typed name above is my electronic signature, and that the information I have given is accurate.

Your request is logged the moment you submit.
The response clock starts immediately.