Medical Records Release Form
Need your medical records?
Just download the medical release form, print it and fill it out completely please.
Perfect! Just scan your records request into an email.
Email the completed form to firstname.lastname@example.org.
*Note* Email in not encrypted. If you prefer to mail your request, you can.
Please address to:
2700 Old Rosebud Rd
Lexington, KY 40509
Just deliver it to our reception team during normal business hours.
Your first records request is always free.