Medical Records/Release

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If you are a requesting a medical record for personal use, or requesting on behalf of a patient such as an attorney for disability, there is a $10 per each request and a 25 cent per page handling fee.

If you are a non–comanaged office and would like to request records, please have the patient fill out the following form. Please click the button below and email the complete form to medicalrecord@DoughertyLaserVision.com. Failure to provide all information requested may invalidate this Authorization.

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