Request Medical Records
Patients and Physicians: Complete the form above and email firstname.lastname@example.org. Our medical records custodian will contact you when your records are prepared. We are happy to email you your records from our secure portal, or you can pick up a printed copy at our local clinic. When you receive the message from our secure portal you will click on the link and follow the simple instructions to access your documents.
Law Firms: All medical records requests should be emailed to email@example.com. We do not accept faxed requests. We no longer send out invoices for payment. We do not accept checks as a form of payment for medical records. The only acceptable form of payment is by phone with a credit card.
Our fee for medical and billing records is $25.00. If you have forms that require a notary’s service, there will be a additional fee of $15.00. Next Level Urgent Care will call you the day the email is received to process your payment by phone. Medical records are released within 3-5 business days of credit card payment.
To avoid a delay in receiving medical records, please have credit card payment available when our custodian of medical records contacts your firm.