Medical Records

You have the right to access your medical records or you may need your records sent to another provider. Please complete the following release of information form and fax it to (207) 494-8471 with a letter requesting what you are seeking to be shared from your record. Please note it may take up to 2 weeks to fulfill your request.

 

In accordance with Maine State Law, a reasonable fee will be charged for copies of your records. The charge for the copies or the report may not exceed the reasonable costs incurred by the health care practitioner in making and providing the copies or the report. The charge for the copies or the report is $5 for the first page and 45¢ for each additional page, up to a maximum of $250 for the entire treatment record. Upon receiving your request, we will send you an invoice with a link to pay online or you can submit a bank check / money order.

 

 

For more information, please contact:

Erika Martin

Quality Assurance Department
Alternative Wellness Services
222 St. John St.
Suite 314
Portland, ME  04102
(207) 494-8010 ext. 123