This form is to request for AllMedPhysicians to send your Medical Records TO another Medical Practice. Form fees may apply as outlined in our financial policy. If you are needing to have us send out your Medical Records, please fill out this form and bring it to us or fax it to us.
Click to Download Form Requesting AllMedPhysicians to Send Your Medical Records.
Please do NOT send us this form by email which is not secure and not HIPAA compliant.

This form is to help in retreiving Medical Records FROM your previous Physicians. We ask that you help us in the process of retrieving your previous Medical Records by downloading, filling out and faxing, or mailing, to your previous Doctor, or Doctors, this Authorization and Request for Medical Records form.
Click to Download Form Requesting Medical Records be Sent to AllMedPhysicians.