Please complete the appropriate forms and bring them with you or fax them to our office at 310-657-0986
Please send these forms to your previous provider to have medical records transferred to Roxbury Pediatrics.
Transfer of Medical Records Request for:
Incoming Medical Records
We are sad to see you leave. If you'd like to request a transfer of medical records to another office, please sign and return these forms to have medical records transferred to another provider.
Transfer of Medical Records Request For:
Outgoing Medical Records