If you are an attorney or work for a law firm, please use this form to request medical records for your clients. Legal record requests are processed by a different Capitol Imaging Services department and are separate from records requests made directly by patients.
Once we receive your request, our medical records department will begin the work to compile your information. A legal records associate will contact you if there is a need for further information or to provide next steps in obtaining your records.
Fields marked with an asterisk are required and must be filled in.