Medical Release Form

BCOG Medical Release Form

Need records sent to you or another medical office?

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

Records Out Request

Records are usually available within 10 days from the time the request is made.

If you are unable to complete the electronic form above, download and complete the paper form below.  The authorization form must be legible and complete.

Looking to send records to our office?

Please complete this form if you would like records transferred from another provider or if we have requested records prior to your visit.

BCOG Medical Release Form