Medical Records Request
To request medical records from Neurological Injury Specialists or its affiliate companies, all requests must comply with HIPAA privacy regulations and office policies listed below.
Required Information
Please include ALL of the following with your request:
- Completed and signed HIPAA Authorization Form
- Patient full name
- Date of birth
- Phone number
- Dates of service requested
- Specific records being requested:
- Office notes
- Imaging reports
- MRI / CT / X-ray images
- Billing records
- Operative reports
- Other medical documentation
- Signed HIPAA release
Incomplete requests may result in delays.
How to Submit Your Request
Email Requests
Please send all medical records requests to:
hello@nervemed.comFor security purposes:
- Include the patient’s full name and date of birth in the email
- Imaging requests should specify whether reports, images, billing or all are needed
Medical Records Policies
- Records will only be released with proper authorization unless otherwise permitted by law
- Requests are processed in the order received
- Processing times may vary depending on record volume and request type
- Additional verification may be required for HIPAA compliance
- Imaging studies may require additional processing time
- Records requests may be subject to applicable copying, preparation, or delivery fees permitted by state law
- Urgent requests must be clearly marked “URGENT”
- Requests for records already released may incur duplicate processing fees
- Our office reserves the right to deny incomplete or unauthorized requests
Imaging Requests
If requesting diagnostic imaging, please specify:
- Type of imaging requested
- Date(s) of study
- Whether you need reports, images, or both
- Preferred delivery method (PowerShare, CD)
