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Medical Records Request by Patient

Medical Records Request by Patient

You may request medical records by completing the Authorization for Release below and submitting them as directed. Additionally, we are pleased to announce that you may view your records through a secure portal known as MED Patient Portal. Contact our office for information on how to register and gain access to the MED Patient Portal or click HERE to access your Patient Portal Account.

Because an actual signature is required to release medical records information, personnel at Minor Emergency of Denton are not allowed to process requests or authorizations received via e-mail. Please download the Authorization for Release of Patient Information (below), complete all required fields, sign it, and mail the form to the Minor Emergency of Denton’s (Medical Records) Department. The mailing address is 4400 Teasley Lane, Suite 200, Denton, TX 76210. You may also fax the completed authorization to 940-383-3815.

Authorization for Release of Patient Information (PDF)

Medical Records In Paper Form

Should a fee apply, Minor Emergency of Denton will charge the following for the copying of health care information. Additionally, the hospital may charge the actual cost of mailing, shipping or otherwise delivering the provided copies.

  • 1-5 pages: No Charge
  • More Than 5 Pages: $25.00 for the first 20 pages and 50 cents for each page thereafter.

Medical Records in Electronic Form

Minor Emergency of Denton can provide patient’s medical records in Electronic form by means of CD-ROMs. The following fee will apply:
Each CD-ROM: $10.00.