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Medical Records Request

A MISSION FOR MICHAEL

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Consent for Release of Information (ROI):

A completed ROI must be on file with AMFM Healthcare in order to release any information.

If AMFM does not already have a signed ROI on file for this request and you are the patient who received care with us, please complete the Consent for Release of Information Form before requesting records. 

If AMFM already has the appropriately signed ROI on file for the requesting party please complete the medical record request below.Â