Request Medical Records

Patients may request a copy of their medical records by calling (317) 834-2020 or (317) 528-2270.

A Release of Information Authorization form must first be completed by the patient or legal guardian. 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 you request a copy of medical records released to another physician for continuation of care there is no charge. However, we cannot release any medical records provided to us by another physician for the continuation of the patient's care.

If the request is for personal or other reasons, there is a charge. Pursuant to Indiana Code IC4-22-2, the fees are 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 ask that our patients fill out the Medical Record Request Form. You may fill it out in the office on your next visit or you can download it.