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Request Duplicate Medical Records

Please complete the form below for any medical records request from 2017 or prior to that year. If you need medical records after 2017, please log into www.e7charts.com to retrieve your medical records at no cost.

If you need medical records from 2017 or prior, the cost of your duplicate medical records is $0.60. Once we have received your request and payment, your duplicate records will be emailed to you within 1-2 business days.

Payment Method :

First Name:

Last Name:

Birthdate:

Phone Number:

Fax Number:

Location :

E-mail Address:

Note: Please use the same email that you provided on the computer registration in the office. e7 Health can only utilize this email to send patient information. If you are unable to use this email, the duplicate records must be picked up in person with a Photo ID.

What duplicate records do you need? Note: Please specify (TB Test, Lab Results, Vaccine Record, Physical Exam, etc.)

Amount :

Street Address :

City :

State :

Zip :

Country :

Card Type :

Credit Card # :

Expiration Month :

Expiration Year :

CVV2:

Street Address :

City :

State :

Zip :

Country :

e7 Health

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Very friendly and super helpful with any questions I had. Very clean and calm atmosphere, all the staff were kind.
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I came to E7 health for a physical exam for employment. Staff was very professional, And I was in and out in thirty minutes
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Staff was extremely friendly, I was able to walk in without an appointment.
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Very friendly, informative, and well versed. Felt well taken care of by the doctor and all the staff. Fast, friendly, considerate, all staff met.
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I was here for an employment physical. They are amazing! I was in and out in less than 10 mins.
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J was super helpful. Very quick and easy.
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Rachel was amazing and I was in and out so quick ! Ready to start my new job ! Thanks 🥰
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