Raleigh Office

(919) 872-0250

Garner Office

(919) 779-6423

After Hours

(919) 831-5394

Medical Records

Medical Records

Transferring From Another Practice

If you are transferring to Raleigh Pediatric Associates from another practice, we appreciate your entrusting us with your child’s health care. To help you request a transfer of your records from your previous physician, we have provided below a Records Release Form. The blank form may be printed and then filled out by hand. Be sure to sign the form, and then send it to your previous physician’s office.

In addition to the Records Release Form below, you will also want to make use of some other forms useful for your first visit, such as a Patient Information Sheet and a Medical History Sheet, available here.

Records Release Form

Transferring Out of the Practice

We are always sorry to have patients transfer out of our practice, but we understand that there are valid reasons for doing so. To help you request a transfer of your records to another office or clinic, we have provided below a Records Release Form. The blank form may be printed and then filled out by hand. Be sure to sign the form, and we would appreciate knowing the reason for your transfer. The signed form may be brought or mailed to our office to request your records to be transferred. Please allow two weeks for your records transfer request to be processed.

Records Release Form

Patient Portal