Medical Records Request

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You can request copies of your medical records by requesting and completing the Medical Records Authorization Form (PDF) and mailing it to the physicians’ office:

Please note: If the medical records to be copied contain psychiatric diagnoses, alcohol/drug abuse or HIV/AIDS information, you must state in your request that TSAOG is authorized to release those records. If you do not include this in your request and the records to be copied contain this information, your request will be returned to you.

To request medical records, please download and print this form.