The booklet, Bridge to Adulthood, is a valuable resource that our 18-year-old and older patients may use for information on becoming responsible for their own healthcare as an adult and transitioning their medical care to an adult provider when necessary.
Requesting a Records Transfer
To help you request a transfer of your records to another office or clinic, we have provided a Records Release Form. The blank form may be printed and then filled out by hand, or you may fill out the form electronically while online then print the completed form.
Be sure to sign the form. The signed form may be brought in person or mailed to our office to request your records to be transferred. Additionally we would appreciate knowing the reason for your transfer.
Please allow two weeks for your records transfer request to be processed.
Records Release Form
Use of Health Information for patients 18 years of age and older
The forms below allow patients who are 18 years of age and older to inform Premier Pediatrics how they would like their Health Information used and with whom such information can be shared.