TOCA Medical Records Request
Medical Records Department
Below you will find the Medical Records Request form. Simply click on the PDF icon, print and fill out the form.
- 1. Fill out top portion with your information.
- 2. Check 1st box if you would like TOCA to release your records.
- 3. Check the 2nd box if you would like TOCA to receive your records.
- 4. Fill out the second portion with the information of the provider/personnel that will be receiving/releasing records.
- 5. Please sign and date the bottom of the page.
- 6. Send request to provider you want to release/send records to TOCA.
- 7. Return by Fax or Email to TOCA for records you want TOCA to release.
- Record requests from TOCA will normally be processed within 72 hours.