Optimize your body's natural healing abilities!

Optimize your body's natural healing abilities!

Optimize your body's natural healing abilities!Optimize your body's natural healing abilities!Optimize your body's natural healing abilities!

Obtaining Medical Records

  

All medical records are confidential and protected by federal privacy and security regulations. With your written authorization, a copy of your medical record(s) can be released to you or transferred to another physical therapist. Due to the current COVID-19 situation, picking up your records in person is not an option at this time.

You have a few options:

  • You may have your medical record(s) mailed to you; or 
  • You may have them e-mailed to you via encrypted e-mail, or
  • You may have them faxed to you to a secure fax number, or
  • You may have them faxed to a physical therapist you designate for      ongoing care. (You must provide the name, fax number, and practice address of that physical therapist or clinic. I recommend sending a discharge summary only as your new therapist will have their own intake paperwork and will perform their own evaluation.

If you are an active patient and have been referred to me by a physician, a discharge summary will automatically be sent to the physician’s office at the time of discharge and no form is needed. 

Please complete, sign and return the medical record release form below as soon as possible, but no later than May 20, 2020. Be sure to indicate how you would like to obtain the medical record(s) and whether or not you would like the entire record or a portion of it.

I will need approximately 5 business days to retrieve and prepare the records. Please notify me by phone or e-mail if you have mailed the form to my office, as I am no longer at the office regularly to receive my mail. There may be a fee for record duplication. Additional restrictions related to COVID-19 may limit my access to your records and cause delays. 

After the closure of the office, rest assured that your records will remain secured per HIPAA regulations and will be shredded after the required length of time.  

Medical Records Release Form

CPT Medical Release form April 2020 (pdf)

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