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Request your records
Request Your Records
Please use the form below to contact us or to request your records.
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Nature of inquiry:
Request healthcare records
Billing or insurance issue
Website Issue
Other
You selected "Records Request". Please select the records you need:
As a former client, an electronic copy of your records is available upon written request for 10 years from your last date of service. You may request your records by completing the form below. You may be asked to verify your identity if your email address does not match what we have in your records. Please allow 1-2 weeks for completion of the request.
Patient records
Financial records
Both patient and financial records
Name
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First
Last
Email
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