Requesting your medical records
is as easy as 1 - 2 - 3!
Complete a request from your smartphone, tablet or computer –
anytime from anywhere!
anytime from anywhere!
1
Access Patient Request
Scan this QR code
with the camera from
your phone or tablet
with the camera from
your phone or tablet
Patient Request boasts a
nearly 100% approval rating
nearly 100% approval rating
“I wasn’t sure I could do this
(I’m 69), but it was very easy to
follow the steps.”
“Very simple to fill out and within a
short period of time.”
(I’m 69), but it was very easy to
follow the steps.”
“Very simple to fill out and within a
short period of time.”
or
2
Complete Online Request
You’ll be guided through every step of the process
3
Review + Sign + Submit Request
You're done!
Your records are delivered right to you!
Electronic Delivery
You’ll get an email with instructions
for retrieving your records. To keep
them secure, you’ll need a PIN that
is sent in a separate email.
for retrieving your records. To keep
them secure, you’ll need a PIN that
is sent in a separate email.
Mail Delivery
Records will be mailed to the address
you entered in the request.
you entered in the request.
Questions
(603) 525-7360
