Dear Dr. Christina
PM Pediatrics

Medical Record Request Form

Please fill out the form below to request records. The records will be sent to the patient’s portal. If the patient does not have a portal, we will require a completed record release form and a copy of your photo ID. This can be uploaded in the form below. The records request department can be reached at 516-207-7960. The patient portal can be accessed here.

If you are looking to retrieve your COVID test results or other lab results, please visit your patient portal or call the office where you or your child received the test. This form is for medical record chart requests.

This survey must be completed in its entirety in order for us to fulfill your request. Partially filled forms cannot be fulfilled.