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Medical Records Transfer Policy
In our on-going effort to better serve our patients, we have teamed-up with Diversified Medical Records Services for a fast, efficient solution for medical records duplication.
Generally, records are copied on Tuesdays.
Procedure:
A copy of our Authorization for Release must be filled out and sent to our office in order for any record to be copied, for any reason.
Download Records Transfer Request Form TO and FROM Lincoln Park Family Physicians
Download Authorization Form for Release of Information to Third Parties
Payment:
There is no charge if records are being mailed directly to your new physician's office.
For all other records copying, including copies for personal use, insurance companies, etc.:
Payment for services must be made PRIOR to the duplication of records.
Please make checks payable to DMRS. Cash and credit cards are not accepted.
Return your Authorization for Release along with your payment to our office. Once payment is received, your records will be duplicated and forwarded to the recipient as requested. The fees are as follows:
- $10 - includes copies of the most recent two-year medical history
- $25 per volume - includes a copy of your entire medical chart. Due to the additional handling procedures necessary, requests for entire record copies may be delayed. Please allow for additional processing time before receipt of your complete copies. You will be contacted regarding any remaining balance should there be additional volumes.
After confirming the receipt of your request with our office, if you would like to follow-up on the status of your request, please call DMRS directly at 1-800-359-8520.