Release of Medical Record | Carefirst Pediatrics

NUESTROS SERVICIOS

New Patient Form

Thank you for choosing CareFirst Pediatrics! Click here to start the forms.

Newborn Paperwork

Forms for our newborn babies, to be completed for the first visit

2024 Updated Demographics and Billing Policy

For all existing patients - to provide us with your most updated demographics and inform you of the new billing policies

Release of Medical Records Form

Provide consent to send or request medical records to/from any doctor's office, hopital, school or facility.

Individual Forms

Release of Medical Record Form

If you are unable to view the form, you may click here to open it in a new window.

This form is utilized as permission to request or send medical records to any institution, free of charge. This includes but is not limited to other doctors offices, schools, and programs. We are not able to send a pdf document of your child's medical records directly to parents via email. You must request a MyChart account to securely access and download records.

If you are changing pediatricians and transferring care, please notify our office to cancel any future appointments and clear any outstanding balances.

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