Patient Form Requests
MEDICAL RECORD REQUESTS
Patient Instructions for Medical Record Requests
The Surgical Clinic has partnered with HealthMark Group to ensure the accurate and timely completion of medical record requests.
Requests may be submitted electronically to HealthMark’s Request Manager at https://requestmanager.healthmark-group.com. Once logged in, select “Submit Request” from the menu options and enter all required fields to provide an authorization directly to HealthMark. Your medical record request will be processed, and a notification will be sent via mail or email once complete and available for download.
Please log in to Request Manager for status updates or to chat with support. If you have any questions, you may contact HealthMark at 800-659-4035 or firstname.lastname@example.org.
The Surgical Clinic has partnered with HealthMark Group to ensure the accurate and timely completion of your FMLA and/or Disability forms.
A signed and completed authorization form is required from each patient.
Each form requested for completion will require a fee to be paid directly to HealthMark Group. HealthMark Group will complete the forms upon receipt of the requested forms and a valid authorization. The estimated turnaround time will be 24-72 hours. If an email is provided, you will receive a response directly from HealthMark Group notifying you of the prepayment invoice. After payment, the completed forms may be downloaded directly through HealthMark Group’s website, or provided directly to you through an agreed to delivery method (i.e. secure email, mail, etc.)
If you would like to inquire on the status of your forms or have any additional questions, please call 972-895-2138 or email email@example.com