Medical release form

Please complete a Medical Release Form -to send us your relevant records. Please fax the completed  form to your other physicians (not us).
 If you think your old records will be important in our decisions, then the only way to guarantee we receive your records in a timely manner is if you physically obtain them from your other physician yourself and bring to your clinic visit with us. PLEASE SEND THIS COMPLETED FORM DIRECTLY TO THE OTHER PHYSICIANS, NOT TO OUR OFFICE as we will not fax for you unless you are in our office. Note, if a fax request is sent to another physician then we usually do not receive this information from your other physician for at least 4-6 weeks.