For your convienience and to expedite your visit, please fill out the registration forms PRIOR to your visit and fax or email them to us at firstname.lastname@example.org.
If you would like us to retrieve your records from your old practice please fill this form in its entirety
If you would like us to release your records to your NEW practice, please fill this form.
We do charge 75 cents per page for the entire chart.
The vaccination record will be sent out at no charge.
Medical Release Form