Requesting Medical Records
You can download and print our Medical Records release form or obtain a form from the front desk at any Retina Centers location. Your records will be sent to you upon receipt of the signed Medical Record Release form.
You will receive a call from our office indicating the cost to copy your records. Retina Centers charges $25 fee for all records requests.
Please allow up to 7-10 days to process your request.
Authorization Signature for Your Records Release
By law, the following authorized people are able to sign for the release of your health information:
- Yourself (not your spouse)
- A parent (for patients younger than 18 years of age)
- Legal guardian (guardianship documentation is required)
- Power of attorney if patient is unable to sign (legal documentation is required)
Estate representative for a deceased patient (estate documentation is required)