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Web primary care by specialist request form; Web to request that a copy of your child’s medical record be released to you or to a designated person or organization (i.e., school, daycare provider, employer), complete.
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Web developed for texas health & safety code § 181.154(d) effective june 2013 please read this entire form before signing and complete all the sections that apply to your decisions. Web primary care by specialist request form; To receive a copy of a medical record, you must complete a release of information form ( english and spanish ).
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To receive a copy of a medical record, you must complete a release of information form ( english and spanish ). We welcome you to use our secure online portal if you would like access to your health records. Texas children’s may verify your. Web medical records request form.
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Only patients or their legal representatives may make a medical record request. Third party requests require an authorization. If you prefer, you may download and complete a printed version of the authorization form. Please mail or deliver the form in person to:
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