Request Records

The records request link is to send your records by E-mail or receive information on how to obtain the records by other means. The person filling out this form assumes responsibility for the information to be factual and used for non-malicious intent.

Records beyond 10 years may not be retrievable. Photos or images may be subject to fees. **Please note that we cannot send expired prescriptions. Glasses have a 2-year expiration and contacts have a 1-year expiration** FEES FOR PAPER COPY OF RECORDS WILL BE INCURRED AND MUST BE PAID BEFORE THEY ARE PRINTED

Please click on the following picture to fill out the request form: