• Medical Records Request Form

  • Thank you for contacting Medical Associates Plus to request a copy of your medical records. Once your request is processed, you will receive notification and instructions on receiving the requested records.

    Questions regarding the status of your request can be submitted by emailing medicalrecordsrequest@medicalassociatesplus.com.

    You should receive a response from a representative shortly.

  • Requestor Information

  •  -  -
    Pick a Date
  • Disclose from / obtain records from

    Obtain Records from this Healthcare Provider
  • Requested Information

    Dates of Treatment
  •  -  -
    Pick a Date
  •  -  -
    Pick a Date
  • Delivery Format

  • Authorization

  • Clear
  • Should be Empty: