Medical Records Release Form

The form below can be used to request release of your medical records to another physician or to you.  Transfer of records to another health care provider is done at no charge.  If you wish to have a copy of your records, the charge is 5 cents per page and postage costs, all usually less than $5-$10.  Please contact the office staff for assistance with this issue.
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Barbara Peters,
May 28, 2018, 10:40 AM
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