281-319-8840 info@acutemedical.co

Records Request

Please fill out the following form to submit a records request. Your credit card will be billed a fee of $75.00 per request.
  • For Medical Records and Billing Records we will need a signed release from the patient or patient’s medical power of attorney attached to this request. Please scan your medical release or power of attorney and attach the records below:
  • Medical Records and Billing Records Processing Fee $75.00. You will get a receipt attached with the copies of records ordered. Records may take up to 14 days for compilation. Usually records can be delivered within 48 hours.
  • Located on the back of your credit card