Records Release Form

If you need a copy of your medical records, or need to transfer records to our office, please use the following form. 

Please note medical records may be accessed by active patients of Rivertown Pediatrics through our Patient Portal! This is no cost to you. However, if we produce your records a fee of $20 may apply. 

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2416 Capstone Court, Columbus, GA 31909 | 706-327-1281 | Fax 706-576-9714

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