A Records Release must be completed to transfer medical records.
The following is for the transfer of medical records due to a change in PCP, or if you are requesting records for yourself. If you are requesting other documentation (school, daycare, sports or health form or vaccine records, please do so through your patient portal. Patient Resources > Patient Portal)
HIPAA requirements state that a singed authorization by a legal guardian must be completed prior to sending or obtaining any client records. Please allow up to 7 days for your request, also please CAREFULLY select all boxes and provide complete information. We will send records by fax unless requesting them for yourself in which case we use a password protected encrypted email.
Download the medical records release form HERE
When complete email your form to IPHCadmin@myupdox.com