Complete the form linked below and email or fax it to the contact listed at the bottom of page two. Our medical records custodian will contact you when your records are prepared.
Our fee for medical and billing records is $25.00, payable by credit card only. If you have forms that require a notary’s service, there will be an additional fee of $15.00. Medical records are released within 5-7 business days of payment.
If you are a patient being treated by Next Level Urgent Care for a work-related injury, FMLA and Short-Term Disability paperwork is not completed during your clinic visit.
All requests must be submitted through our online form for review. Submission does not guarantee completion, as requests must meet specific criteria. If eligible, a fee will apply prior to completion.
If you are a Next Level PRIME member, please click the orange button to contact your PRIME Care Navigator.
If you are a Houston ISD patient, we are unable to complete FMLA forms. Please contact your benefits center for further assistance.
We’re open today from 9:00 AM–7:00 PM in observance of Independence Day. We’ll resume our normal hours of 9:00 AM–9:00 PM tomorrow. Have a safe and happy holiday!
