Patients may request a copy of their medical records for their personal use or for delivery to a physician outside of Urology San Antonio by submitting the Medical Records Request form found on the Medical Records page of our website.

A medical records release form is required to obtain a copy of your medical records. Records will be copied and mailed to you after the release form is received. There is a fee for this service. Please contact our office at (920) 730-8833 or toll free at (888) 383-3039 for more information.

The Medical Board may take any action against the physician which is appropriate for failing to provide the records within the legal time limit. This can range from making sure that the doctor actually does provide you the copy you requested, to a citation and fine or disciplinary action against the physician's medical license.

You may request your medical records by printing and filling out an authorization allowing us to release your private health information. You must then send us the form by mail to: The form must be filled out completely in order to process your request. Patients and legal offices (attorneys) obtaining medical records will be billed $0.75 per page to cover the cost of copying fees. Life Insurance companies and their representatives will be billed a flat rate of $175.00.

All requests for medical records must be submitted in writing along with proper authorization. Requests can be faxed to (920) 831-2968 or mailed to our office: The physicians and staff at the Hand and Upper Extremity Center of Northeast Wisconsin hope that your care and experience with us is pleasant and productive. We appreciate the confidence you have given us by placing your care in our hands.

You may fax or call the Orlando location to request a copy of your medical records. Please note that you will need to sign a release in order for us to furnish your records to you. Please allow 72 hours to process the request.

You can make a written request to either review or obtain a copy of your medical records pursuant to Health and Safety Code sections 123100 through 123149.5. The laws which authorize access to your records are available on the Internet and you might wish to review them for information about time lines a physician has to meet and the fees he or she may charge to provide the records. You can view these laws at the following Web site: http://leginfo.ca.gov/calaw.html

We must receive a signed authorization to release records. Patients over 18 must sign the release themselves. We will release records to specialist physicians at no charge. A $15.00 fee will be charged per medical record (child) to transfer records to other physicians or for additional record copies.

Anyone you give privileges and your password to. This includes your chiropractor, acupuncturist, attorney, or even your employer. With your permission, even family members have access. But no one gets to your records without your okay.

When compiling medical records in response to an ADR request, attach a copy of the ADR to the set of medical records that correspond to that ADR letter. We often receive records with several ADR's attached. We also receive records bunched together that are for different beneficiaries. We log only one ADR, for the claim listed on the top ADR, according to the DCN on the front of the first ADR letter.

If you made your request in writing for the records to be sent directly to you, the physician must provide copies to you within 15 days. The physician can charge a reasonable fee for the cost of making the copies. If the physician's office advises you that a fee will be charged for the records, the medical records do not need to be provided until the fee is paid. If the physician does not comply within the time frame you can file a written complaint with the Medical Board.