Medical Records

If you would like to request a copy of your medical records, please download, print, and complete in its entirety the Authorization for Release of Medical Information.

Please fax form along with a copy of your State Identification Card, such as a driver's license to 646-962-0602. Failure to comply with this protocol will delay, or may even void your request.

Please note, the retrieval of your medical records may take as long as 14 business days.

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