New patient forms for our Indianapolis fertility center
The entire team at our Indianapolis fertility center is here to help you on your way to a family. All new patient registration forms can be completed via EngagedMD. You will receive information on how to complete when you schedule your visit.
Medical Release
- Authorization for the Release of Medical Records
- Authorization for the Release of Medical Records – Print & Download | en Español
We have partnered with MediCopy to fulfill your Release of Information requests. MediCopy is fully HIPAA compliant and adheres to all state and federal regulations concerning release of medical information. To request your medical records please fill out the Authorization for the Release of Medical Records form using one of the options above.
Patients can request copies of their medical records at no cost, but delivery fees apply for postage! Please provide an email address on the authorization to expedite the process and delivery method. Records sent via email or to another provider are complimentary. Requests are completed within two (2) business days after receipt by MediCopy.
If you have any questions, please contact MediCopy: Online Chat: MediCopy.net | Phone: 866-587-6274 | Ask a Question: https://medicopy.net/contact
Learn more about MediCopy’s Release of Information service
