Medical Record Request

Obtaining your medical records requires a 48 hour notice. Please call 281-580-6171 or stop by your location to speak to one of our staff members. If you would like to request information online, please fill out the forms below to help in the process. 

Your request will be processed within 24-72 hours, during normal business hours, Monday - Friday, 9:00 am - 4:00 pm, excluding holidays. If you do not accept the terms of this disclaimer, you will not be able to process your request on-line.
If you have any questions regarding the use of these forms, please contact our office during normal business hours.

Please note: Patients will be required to provide a photo ID when retrieving records in person. If you are requesting your films to be mailed, please provide a copy of your ID by faxing us at 281-754-4220 or email to

Use and Disclosure (to obtain your records from TOPS)
Authorization to Release Records to TOPS (for obtaining prior breast images)