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Patients may request a copy of their medical records by calling (317) 834-2020 or (317) 889-7906.

A Release of Information Authorization form must first be completed by the patient or legal guardian.

PLEASE NOTE: If a patient has granted Power of Attorney to someone, we must see the Power of Attorney prior to processing the request for medical records.

If the request is for personal reasons, there is a charge.

If you request a copy of medical records released to another physician for continuation of care there is no charge.

For all other requests pursuant to Indiana Code IC4-22-2 our fee is as follows;
  • $20.00 for labor which includes the price of the first 10 pages
  • $ .50 for each pages 11 through 50
  • $ .25 for all pages over 50
  • $10.00 for request of return of less than 2 days.
  • $20.00 for certification if requested.

We can not release medical records provided to us by another physician for the continuation of the patient's care.
We ask that our patients fill out the Medical Record Request F form. You may fill it out in the office on your next visit or you can download it from our site.

[Click Here to Download a Printable PDF file]

Our information is available in a PDF format. If you do not have Acrobat Reader,
please click the icon to download.