Because records may contain sensitive information, we may ask you to sign and return the enclosed Authorization for Release of Medical information.
There is a fee of $20.00 for each medical record transferred. The fee is expected prior to release of records. Checks should be payable to: Pediatricians, Inc.
If you insist on records on off-site storage, there is an additional charge of $20.00 to cover the cost of retrieving the record.
Please Note: Medical records cannot be copied upon demand. The Normal completion time is 5-7 business days. Your record will be placed in long-term storage for 7-10 years.
After that time, it may not be available. We suggest you make a copy of any pertinent information, I.e Immunizations, for your personal records.
If you have any questions about this form or the request, please call at (781) 729-4262