Please use the form below to request a Medical Chart. Once submitted please use the Checkout buttons or QR code below to pay for your request. If you do not submit payment or request physical deliver we will send an invoice via Paypal to the Primary Contact Email address. If we require verification documents we will be in contact via the method you request below prior to releasing any data to you. We appreciate your business and the opportunity to serve you.
Frequently Asked Questions
We charge a non-refundable $35.00 to research, extract, and validate requests. We will send the chart via a secured email for free. If you require physical media (USB-A flash drive, DVD, or printed on paper) we provide those at an additional $20 plus $0.25 per page for paper export fee that is charged only after we confirm we can export the chart for you. We will send an invoice via email or call you collect that fee prior to shipping the chart to you.
We pride ourselves in being able to have your data on its way to you within one business day. You will get your data fastest if you choose the basic Secure Email option. If there are any delays we will keep you updated via email or phone about the status of your request.
To find the chart we will need to know as much as possible about the person within the chart. This means full name, Date of Birth, Date(s) of Service, Doctor or Provider seen, MRN#, Patient #, and/or other identifying number.
To verify permission, if you are the patient, we will only need your contact information and an uploaded picture of your unexpired Drivers License or Government issued ID. If you are anyone other than the patient we will need you to upload or provide us with corroborating evidence that you are allowed to view the requested chart. This could be in a number of legal instruments or documents.
We will communicate with you through email or phone (whichever you prefer) to collect other data to help us locate it. In the rare circumstance where we cannot locate a chart we will attempt to communicate with the original Practice Owner to locate it.
We do not refund the $35 chart request fee for any reason. We do not collect Physical Media fees until we validate that we have a chart to send and once we hand the package to USPS that fee cannot be refunded.