Request Your Medical Records

For personal use or delivery to a provider outside of Regional Urology, please complete the following form.

Download: Authorization to Disclose Protected Health Information
Fax the form to (318) 683-0743, or submit it by mail or in person to:

Regional Urology
Attn: Medical Records
255 Bert Kouns Industrial Loop
Shreveport, LA 71106

Requests are normally processed with in 15 days; however, we try to get them processed earlier. We will notify you when your records are ready for pick up.

Please be prepared to present a photo ID when picking up your records. If extenuating circumstances prevent you from picking up your records in person from our business office, call (318) 683-0411 extension 251 to arrange an alternate delivery method.

 

Legal & Insurance Requests

Insurance companies and law firms requesting patient records may call (318) 683-0411 or fax your request to (318) 683-0743.

 

CONTACT US

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