Patient Forms

Medical Records

OBTAINING COPIES OF MEDICAL RECORDS

To protect the privacy and confidentiality of our patients' personal medical information, completion of a medical record release form is required when records are sent to a third party, such as another physician or health care provider, an attorney or insurance company.

Release forms may be picked up from our office or downloaded here. Please mail, fax or bring to the office. You will be notified of any copying fees associated with your request. Records will not be sent until prepayment is received. Please allow 7-14 business days for the processing of these requests.

Records are generally sent to other doctor's offices at no charge.

Request For Medical Records to come to The Family Doctor

Records Release of information from The Family Doctor

COPYING FEES

Pursuant to Section 90-411 of the NCGS, the maximum fee charged for liability requests are $.75 per page for the first 25 pages, $.50 per page for pages 26 - 100, and $.25 per page for all pages over 100. We are allowed under this law to charge a minimum copying fee of $10. Other types of requests will be charged $1 per page.