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, or you may fill out the form electronically while online, then print the completed form. Be sure to sign the form, and then send it to your previous physician's office.
Viewing the form requires Adobe Acrobat Reader, available for free from the link at the bottom of this page. If you are using an older version of Adobe Acrobat Reader, forms created using a newer version may give an error message. If this is the case, please download and install the latest version using the link below.
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 by using the First Visit Forms link on the left side of this page.
