Patient Resources
MEDICAL RECORDS
Need a copy of your child's records for a new provider, a school, or your own files? Here's exactly how to request them.
How to request records
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Complete the release form
The release requires a signature, so it's a short PDF. Download it, fill it out, and sign.
Download the release form (PDF) -
Send it to our records team
Email your completed form to cmorton@texaschildneurology.com, or bring it to our office. If any fee applies, it's collected before records are released.
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Receive your records
Please allow up to five business days for all nonlegal requests. Records can be faxed, emailed, mailed, or picked up at our office. For email delivery, written permission is required; our emails are encrypted, but no email is ever guaranteed secure.
What records cost
- $10.00 First 20 pages
- $0.25 Each page after 20
- No charge Sent to a licensed Texas provider, insurance company, or state agency
Former patients of Dr. Gossett
If your child was a patient of Dr. Gossett and you need records sent to Orchard Park Child Neurology, you don't need the release form and there's no charge. Email Crystal at cmorton@texaschildneurology.com with your child's first name, last initial, and date of birth, using the subject line "Referral to Dr. Gossett," and she'll send the referral electronically.
QUESTIONS ABOUT YOUR REQUEST?
Our medical records team member, Crystal Morton, is happy to help with the form or the process.