Request Medical Records

Learn how to request patient medical records from NeuMed.

Patients and Physicians:

Download Medical Records Release Form

Complete the request form pdf at the link above and then complete and attach to the form located at the bottom of this page. 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.

Law Firms and Insurance Companies:

We do not accept faxed requests.  We do not accept checks as a form of payment for medical records.  The only acceptable form of payment is by 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.  Medical records are released within 3-5 business days of credit card payment.

Medical Request Form

"*" indicates required fields

Patient Name*
Max. file size: 20 MB.
Do you require a Notary service?*
This field is for validation purposes and should be left unchanged.