Medical release form
1. Print the Medical Release Form.
2. Fill out the top of the form and sign the bottom.
3. Fax the completed Medical Release Form back to your primary care provider or medical clinic.
4. Our fax number is 505-212-3263
5. Please call us to ensure your medical records were delivered.
Please make sure to call and follow up with your primary care provider or medical clinic when you fax a medical records request to ensure it is handled in a timely manner.
If you have any questions, please feel free to call us at 505-990-3978.