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Form

Patient Forms

Requesting Your Medical Records

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Need a copy of your medical records? Simply complete our release form using the necessary form below.

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Request Options:

  • Electronic Copies - Available upon request.

  • Paper Copies - A $25 processing fee applies.

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Transferring Records to Another Physician?​

We're happy to send your medical records directly to another healthcare provider free of charge upon receiving a completed release form.​​

New Patient Form Pack – Includes all new patient forms.​

Authorization to Release Patient Information TO Bajaj & Co. Endocrinology

Authorization to Release Patient Information TO Bajaj & Co. Endocrinology

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