Request Medical Records

To request a copy of medical records fill out the form below.

Fill out my online form.


For questions regarding medical records, or to obtain the status of your request contact us at (919) 787-6131.
You can download a Consent to Release Information form here to fill and email completed form to or fax to: (888) 890-6295 or physically bring to: 3125 Poplarwood Ct Suite 203 Raleigh, NC 27604