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Request Records
 
Our patients have access to their prescription information and records at any time by calling our office at (804) 272-0848 or the business after-hours cell phone at (804) 263-7845. We will do our best to retrieve your medical information in a timely fashion, and please allow 24-48 hours to complete your request.
 
To submit a request for your records to be sent to you via fax, email, or snail mail, please fill out the form below.  Please indicate your date of birth in the Comments section, and indicate how you would prefer for your records to be sent to you. If you would like it faxed, please also include your fax number in the Comments section.
 
Thank you!
 
First Name:
Last Name:
Email:
Phone:
Address 1:
Address 2:
City:
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Zip:
Comments:
 
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