Record Inquiry

If you have questions about a record you can fill out the below form. If you have not heard from us within 3 business days, please check your spam folder as submission of this form does not deem the request as received.

• Please do not include any personal information outside of what is required on this form (such as DOB or SSN).
• Please note that any records that contain medical information will fall under HIPAA regulations. We will also be following up to obtain further documentation outside of this contact form.