Magnolia Dermatology has partnered with Sharecare to fulfill your requests for records.

 

If you are our patient and would like to request your medical records, please click on the link below to complete your request for medical records. You will be required to provide a valid email address and a government-issued ID.

 

https://submissionportal.hds.sharecare.com/lfserver/PatientRequest?ClientID=MS150

 

If you are unable to complete the electronic form above, download and complete the paper form below. Authorizations that are illegible or incomplete will be returned. Please note the processing of records is faster using the online form above. Records are usually available within 10 days from the time the request is received. To arrange for another individual to pick up the documents for you, please indicate that on the authorization form, and ask them to bring their government-issued ID.

 

Only the patient, parent/legal guardian, or the patient’s legal health care representative can sign the form to release medical records. If you are requesting records on behalf of the patient or as the patient’s representative, please provide a copy of an Advance Directive/Durable Power of Attorney for healthcare/ Conservatorship.

 

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Request Submission for Third Party Requesters

 

If you are an attorney, insurance company, or any other entity requesting records from our facility, please click on the link below to upload your request along with the patient’s authorization.

 

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When will my online medical record request be ready?

 

Your records will be ready in 3-5 business days from the receipt of your electronic request.

 

How do I check the status of my request?

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How do I pay for my records?

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How do I contact Customer Service?

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