MEDICAL RECORDS REQUEST FORMS

Patient Instructions for Medical Record Requests

Dallas Pain Consultants outsources our release of information process to HealthMark Group. To follow up on the status of your medical record request, you may contact HealthMark Group directly at 800-659-4035 or status@healthmark-group.com.

HealthMark Group fulfills all patient requests for personal copies at no charge to the patient. A complimentary copy of your record will be made available through HealthMark Group’s website, www.medrelease.com/360. First time users are required to register for an account before accessing the website.

You may also submit a request electronically to HealthMark Group by registering for an account at www.medrelease.com/360. Once logged in, you may select Submit Request from the menu options and enter all required fields to submit an authorization to HealthMark Group directly. HealthMark Group will process your medical record request and provide notification via mail or email once complete. A complimentary copy of your record will be made available for you to download through HealthMark Group’s MedRelease 360 website.

Select Release Form

Request medical records be released to Dallas Pain Consultants

Record Release to DPC

Request medical records be released from Dallas Pain Consultants

Record Release from DPC