How to create a new records request as a patient
In the dashboard, click “Records” to begin your request.
Search for the custodian’s state and name to select them for the request. (The custodian is the provider or facility in possession of medical records).
You will need to specify who you are requesting records for. If you do not see the name of the individual for whom you are requesting records, click “Someone else” to enter their information.
Next, select the dates of service you would like to retrieve records from. There are 4 options, and a calendar will appear when you select any option except “All.” The options are as follows:
This will request all of the individual’s records from this provider.
This will select only the dates of service after the selected date
This will select only the dates of service before the selected date
This will select only the dates of service between two selected dates
You can either electronically sign our form by clicking “Patient e-Authorization” or upload your authorization in a PDF file by clicking “General Release.”
If you choose to e-sign your authorization, you will need to fill out your full name, initials, date of birth, and specify whether you are signing for yourself or on behalf of the requestor. Social Security number is optional. Once finished, click “Accept and Sign.”
If you would rather submit an existing authorization, either drag and drop the PDF file from your computer or click “Browse For A File” and select it via your file explorer.
In the next window, you will see an estimated cost for the requested record retrieval services. Please note that a finalized cost will be determined based on custodian fees and request details once your records are ready to be downloaded.
You will need to authorize a credit card for payment by entering your initials into the blank field. Your payment will be taken automatically once your request has been fulfilled unless the final price exceeds $250. If this is the case, you will be asked to authorize the final price before you can download your records.
After clicking “Confirm Payment, you will be asked to review the request details to ensure accuracy. Check each section, correct any errors with the “Edit” button, and click “Submit Request” to send it to the selected provider or facility.
You will be notified via email when your request has been processed and your records are available for download.