Medical Records

Your records are protected.

A signed medical records release is required to transfer your medical records from another medical provider or practice to us. To start the process, please fill out and submit the form. Once received our staff will initiate the request. If you have questions or need help, please contact your office location. You can also complete this form in person at your next office visit.

Need to fill out new patient forms?

New patient Intake


Please fill out the form completely. We need the full address, phone and fax number of the sending office. Physician Care Centers’ office details can be found here. Saving your progress will email you a link to finish later.
Encrypted HIPAA compliant form |