Medical Records Release Form

Need your medical records?

Just download the medical release form, print it and fill it out completely please.

I Prefer To Email My Request

Perfect! Just scan your records request into an email.

Email the completed form to

*Note* Email in not encrypted. If you prefer to mail your request, you can. 

I Prefer To Mail My Request

Please address to: 

Lexington Podiatry
2700 Old Rosebud Rd
Suite 110
Lexington, KY 40509

I Prefer To Drop It Off In Person


Just deliver it to our reception team during normal business hours. 

Is There A Charge For Medical Records Requests?

Your first records request is always free.