- In order to release copies of your medical records, your written authorization is required.
- There is a $25 fee for the reproduction of medical records.
- Medical records are released on a CD.
- Please allow 14 business days for the records to be available. Your records will be mailed or you will receive a phone call to let you know when the records are ready to be picked up. Records will not be released until the payment is received.
Instructions:
1. Download/Print the Medical Records Release Form. Print and fill out the form.
2. Send the form to our office:
Fax # 978-692-5995
E-mail it to us at surgery@familyeyemd.com
U.S. Mail: 5 Cornerstone Square, Westford, MA 01886
3. Pay the $25 fee:
Click on the “PAY BILL ONLINE” icon on the bottom right of the website.
On the next screen, “Make a Payment – Step 1 of 3”, fill in the information for the PATIENT whos’ records are being requested.
In the notes section, please type “RECORDS”.
Click “Continue”
On the next screen, “Make a Payment – Step 2 of 3”, fill in the information for the person whose name is on the credit card.
Click the button below to download our Medical Records Request form.
