1317 W. Diversey Parkway
Chicago, Illinois 60614 (map)
PH: (773) 665-9355
FAX: (773) 665-0403
Chicago Family Practice Since 1994

Medical Records Transfer Policy

In our on-going effort to better serve our patients, we have teamed-up with Diversified Medical Records Services for a fast, efficient solution for medical records duplication.

Generally, records are copied on Tuesdays.

Procedure:

A copy of our Authorization for Release must be filled out and sent to our office in order for any record to be copied, for any reason.

Download Records Transfer Request Form TO and FROM Lincoln Park Family Physicians

Payment:

There is no charge if records are being mailed directly to your new physician's office.

For all other records copying, including copies for personal use, insurance companies, etc.:

Payment for services must be made PRIOR to the duplication of records.

Please make checks payable to Lincoln Park Family Physicians. Cash and credit cards are not accepted.

Return your Authorization for Release along with your payment to our office. Once payment is received, your records will be duplicated and forwarded to the recipient as requested. The fees are as follows:

After confirming the receipt of your request with our office, if you would like to follow-up on the status of your request, please Call LPFP at (773) 665-9355.

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