Appointment
Medical Records Request/Release

These forms can be completed online, faxed to 972-733-6564, mailed or dropped off at our office.

To send or transfer your records to/from another provider such as a previous primary care physican, specialists, and mental health providers – choose one of the following

Medical Records to be Printed form to print medical records for your own files. Please note, a fee will be charged and must be paid prior to receipt of the printed medical records.

©2022 Girls to Women/Young Men's Health & Wellness
Dallas : 972-733-6565
Fort Worth : 817-524-1811 McKinney : 972-502-9099

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