fbpx
  • Home
  • Patient Care
  • Medical Records

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 Tempe 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
    Sonoran Spine
    1255 W. Rio Salado Parkway, Suite 107
    Tempe, AZ 85281

After downloading and filling out the form, please mail or fax us your request. Sonoran Spine 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. 

Forms not working?  To view and print these forms, you will need the free Acrobat Reader. 

Click here to download it now.

Print Email

Top Doc Awards

Black Canyon City *New Location* 
19251 E. Oasis Dr, Black Canyon City, AZ 85234

Gilbert *Updated Address*
3717 S. Rome St. Ste 106, Gilbert, AZ 85297

Glendale 
5681 W. Beverly Ln, Ste 101, Glendale, AZ 85306

North Phoenix *New Location* 
33300 N 32nd Ave, Ste 101, Phoenix, AZ 85085

North Scottsdale (Thompson Peak) 
20401 N. 73rd St, Ste 155, Scottsdale, AZ 85255
 

Scottsdale (Shea) 
9700 N. 91st St, Ste B108, Scottsdale, AZ 85258

Show Low *Updated Address* 
4951 S. White Mountain Rd, Building A, 2nd Floor,
Show Low, AZ 85901

Queen Creek *New Location*
37200 N. Gantzel Rd., Ste 240, Queen Creek, Arizona 85140

Tempe 
1255 W Rio Salado Pkwy, Ste 107, Tempe, AZ 85281