If you would like assistance with getting a copy of your medical records and have seen a doctor within the last year, you may download our medical release form that is listed below.
Please provide us with as much information as possible when filling out the medical release form, sign, date, and fax it back to us upon completion. After we receive your completed release form, we will forward this request to your doctor's office.
Assistance with obtaining a copy of your medical records from your primary care or treating physician's office is an extra and complimentary service we provide to our patients. Nonetheless, some doctor's office may charge a fee to obtain a copy of the patient's medical records. If this occurs, the patient would be responsible for any fees imposed by the corresponding doctor's office.
If you do not have sufficient medical records at the time of your visit, it is possible that you may not receive a recommendation to use cannabis during your initial visit. The doctor will ask you to come back for a follow up visit, at no additional cost, once your records arrive.
Alternative Care Clinics Release Form
* All emails will be strictly confidential