Contact Us

Medical Records Request

Please contact us at 713-791-9966 to request records. A minimum fee of $25.00 applies. You may download the release form here:

Medical Records Request Form

You may opt to email the completed Medical Records Request Form to mail@dermsurgery.org or use the following form to upload the completed document:

Medical Records Request Form Upload

  • Accepted file types: pdf, gif, jpg, png.
    Click button to upload your completed medical records request form