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Personalized Pain and Spine Care

Medical Records Request 

Options for requesting release of medical records

Requesting from the new practice/office

The preferred method would be to have your medical records sent directly to the office of another physician, provider or medical practice that you designate. You will have to sign a Release of Medical Records form from the requesting practice/office.  That signed Release should then be faxed to our office at (512) 265- 9680.  Once the signed Release is received and reviewed, the records would then be faxed back to the requesting practice/office using HIPAA-compliant protocol. If you select this method, no further information is needed.

Self-request of medical records

Another method would be to copy and past the link provided into your internet browser.  It will take you to a site to fill out the HIPAA-compliant Release of Medical Records. You can use a Google account or set up a new account using a desired email address and a desired password for the account. Once logged in, you will complete the form.  The form will ask for information to identify you and where you would like for your medical records to be sent. Once completed you will then e-sign the Release.  The signed Release will then be available to be reviewed. Once reviewed, your medical records will then be released to whomever you designate. It is recommended that they go directly to another physician, provider or medical practice office via fax which must be provided on the form, but you can request that they go directly to you as well. If you request that the medical records be sent to you, the records will be e-mailed to the email address that you provided in the form and they will be password protected. The link to self-request medical records will be provided after completing the information below.

Self-request of medical records to be mailed

If you would like the medical records to be printed out and mailed to you through the US Postal Service, select that option. A $25 fee will be requested. Please remit via check to Ibex Medical Solutions, PLLC or Wesley Foreman, MD and mail to 5900 Balcones Drive, Ste 8235, Austin, TX 78731.” The link to self-request medical records will be provided after completing the information below.

Request Medical Records

Please click on the link to complete the Release of Medical Records form or copy and paste into your browser.
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