Get your Medical Records from DCI

To initiate a medical and/or billing records request, please follow these steps:

1. Download the Form: Locate the appropriate records request form from the options provided below.
2. Print the Form: After downloading, print the form to complete it.
3. Fill Out the Form: Complete all required fields with accurate information.
4. Submit the Form: Send your completed form to the designated DCI location. You can submit the form in one of the following ways:
   • In Person: Bring the form to the nearest DCI location.
   • By Fax: Send the completed form to the clinic’s specified fax number.
   • By Mail: Mail the form to the clinic’s designated address.