Request Medical Records

Dear Patient,

JMS Scanning & Copy Services, Inc. will be handling your request for copies of your medical records.

The release form MUST be completed in order for us to process your request. It is important that you fill out every line of this authorization; missing information could delay your request.

If you have any questions regarding how to fill this form out, please feel free to contact us at 631-345-9000.

Thank you,
JMS Scanning & Copy Services, Inc.
 



180 East Pulaski Road, Huntington Station, New York 11746
Phone: (631) 425-2121   Fax: (631) 425-2193

If you need information about our services, please call us at the phone number above.

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