Begin Your Secure Records Request

Follow the steps below to submit a request. Please note, it may take up to 14 days for the request to be completed. 

"*" indicates required fields

Name*
Date of Birth
Your information is kept private

By submitting this form you agree to our terms of use and privacy policy; you consent to receive recurring communication and digital messages (including, but not limited to, SMS and email) from Legacy Healing Center.

Disclaimer: Legacy Healing Center (LHC) provides this medical-records request service solely for the release of existing health-care documentation to the patient or an authorized representative. Submission of a request does not guarantee release; all requests are subject to verification of identity, completion of required HIPAA authorization forms, and compliance with federal and applicable state privacy laws. Processing may take up to 14 calendar days from the date all required documentation is received. Reasonable copy and mailing fees permitted by law may apply. Information supplied on this page is for administrative purposes only and is not intended as medical advice or a substitute for professional diagnosis or treatment. If you have urgent clinical needs, contact your physician or call 911 in an emergency.