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REQUEST FOR MEDICAL RECORDS

To obtain copies of your records, you must complete and sign the Record Request Form. -------------------------------------------------
medical record request form
REQUEST FOR MEDICAL RECORDS: Please download the Medical Record Request Form (above) . The Request must be received via Mail, Fax or Email. We will inform you of any applicable charges. The Request for Records MUST include: the Patient’s name, Birthdate, best Phone number for contact, Address along with exactly what records you are requesting. Correspond with us : Phone: 973 762-8344 Fax: 973 762-1626 Email: SoMountainOrtho@gmail.com U.S. Mail South Mountain Orthopaedics, Attn: Medical Records, 61 First Street, South Orange, NJ 07079 OBTAINING YOUR RECORDS: We will require at least three (3) weeks advanced notice for all requests. We have very limited staff during the closure transition. Please make arrangements to pick up your records. There are fees for copying and/or faxing records. All requests must be in writing and signed by the patient or legal guardian.
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