Medical Records
A Release of Information Authorization Form is used by an individual to consent to the release of his or her medical records or x-rays to a new or different physician or health care provider. This release is also often used to assist in a job application or when applying for certain insurance. A parent or legal guardian may provide this authorization to consent to the release of records. A person who has power of attorney may also use this form. To protect a patient's privacy, the law permits disclosure of information only if the patient or his legal representative consents in writing or if the law otherwise permits it. We can send your medical records by email, by fax, by mail or you can pick them up at our Mesa office.
To Obtain an Authorization for Release of Information
| By Phone: | (480) 962-0071 | |
| By Fax: | (480) 962-0590 (Attention: Medical Records) | |
| By Mail: |
Medical Records |
After downloading and filling out the form, please mail or fax us your request. Sonoran Spine Center makes every effort to fill medical records/x-ray requests in a timely manner. If the requested records or films are stored off-site, some records requests can take up to ten business days to process. X-rays/films are to be returned after their use per this request.
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Contact Us
To call or request an appointment:
Phone: 480-962-0071
Use the Appointment Request Form
Sonoran Spine Center Offices:
Phoenix | 480-962-0071
Scottsdale | 480-962-0071
Glendale | 480-962-0071
Mesa | 480-962-0071
Gilbert | 480-962-0071
Sonoran Physical Therapy
and Wellness Center:
1432 South Dobson Road, Suite 209
Mesa, Arizona 85202
Phone: 602-443-6480
Web site: SonoranPT.com
Sonoran Spine Research and
Education Foundation:
1432 South Dobson Road, Suite 201
Mesa, Arizona 85202
Mesa Phone: (602) 443-4169
Phoenix Phone: (602) 443-1424
Web site: www.spineresearch.org





