Medical Records Request

About Medical Record Requests

Your primary care physician or other specialists may need information about your treatment in order to make informed recommendations about additional care now or in the future.

Copies of pertinent medical records or other information are available to the patient or an authorized representative for a nominal fee after we receive a signed release. While we are happy to provide these records to assist in your care, we want to be sure that your privacy is protected, and that information is sent only to those doctors authorized by you to receive them.

You may request and receive medical records using our secure Electronic Form.

Alternatively, you may Download this Authorization Form allowing us to share these records.

Be sure to print a copy for each individual who is authorized to receive records.

After filling in the required information, you may mail the form(s) to the office you typically visit, or bring it/them with you to your next appointment and give them to the receptionist. We’ll do the rest.

Treating Pain & Changing Lives

Nobody wants to live in pain. The patients featured in these stories suffered real pain and wanted their lives back — so they took action. And so can you.

  • Richard Carroll

    They make me feel very welcome and I notice all the other patients around me are made to feel welcome, too. I definitely feel that ... Read Full Story

  • Dianne N.'s Story

    Coming to National Spine and Pain Centers has been a very positive experience for me. I would highly recommend them. Read Full Story

  • William F.'s Story

    My pain now is manageable. And that's all I can ask for. At the end of the day, I'm never going to be pain free, but this is ... Read Full Story

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