MEDICAL RECORDS RELEASE FORM

To obtain a CD copy of your medical records, click on the link to the Medical Records Release Authorization Form.

Complete the form in its entirety, including the name of the physician you want it sent to, or your name.

Mail the form to the address on the form along with  $20 for Shipping and Handling.

Checks should be made out to Rising Health. Your CD will be mailed via USPS with Signature Required within a week of receiving your form and payment.

Thank you,
Rising Health
Custodian of Records

Download your Medical Records Release Form
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