You must submit a request in writing if you would like a copy of your medical and/or billing records; this is provided on compact disc media.  You may use the form “Authorization for the Release of Medical Records” found on this website in the section ‘Practice Forms’.  You will need to specify the dates of service and types of medical information to be included, as well as the reason for this request. If you are requesting records to be sent to another medical provider, whether you are transferring care or for any other reason, the first copy is provided free of charge. A $30.00 fee will be collected for each subsequent copy that is requested, as well as for any copy provided directly to the patient.