Medical Records Release Form

Please complete our medical records release form below so that we can create your child’s chart in our system as well as request your child’s records from your previous doctor.

If you would like to provide authorization for other adults (grandparents, aunts, uncles, etc.) to bring your child into the office and/or receive results or follow-up instructions, you will also need to fill out our authorization form.

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To become a new patient, please use the form below.

we love hearing from our patients

My daughter was sick, and we had just moved here. I got my daughter in as a new patient and treated the same day. It gave a worried mama great comfort.

- Shannan H.

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