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To request medical records, please download this word document.

Request Medical Records

Make sure all of the fields in red are completely filled out. The second page is only necessary if you are requesting the records be released directly to the patient or patient's legal representative. You may fax or mail this form to LMSC, Attn: Medical Records.

New patients and patient updates:

Please fill out all pages. If faxing back to our office, please include the patient's current insurance card. For anyone under the age of 18, fill out the "Minor patient packet" and include a shot record.

Adult patient packet

pat packet.pdf

Minor patient packet

pat packet minor.pdf

DOT Physical Exam Requirements

DOT Requirements

Phone: 936.336.6439

Fax: 936.336.6517