Medical Records and Fees

Medical records are the property of
Mt. Laurel Family Physicians.
Every patient has the right to receive a
copy of their records once we have been provided
with the properly executed authorization form.

If you wish to have us send your
records to another physician

Click Here to print the request form.

Once completed send your request back our office
with a check for $20.00 made payable to
Mount Laurel Family Physicians.
Your records will be sent within 30 days.

If you wish to request your records
from your previous physician

Click Here to print the request form.

Once you have completed the form you can
mail it directly to your previous physician.

Medical Records and Fees

Medical Records

Administrative Fees

We continue to strive to keep your cost of health care affordable.
Your understanding is greatly appreciated.

$5.00 Fee
Forms requiring a physician's signature only

$10.00 Fee
Disability forms (NJ State temporary disability excluded)
Forms required by employers
FMLA forms
Gym memberships
Immunization records
Motor Vehicle forms
Physical Forms (when not completed at the time of the office visit)
Dictated letters and reports
Any other miscellaneous forms not listed above

Fees are subject to change without notification.