Download BJCBR Records Request Form

In order to make the process as convenient as possible, there are a variety of ways that a patient can acquire a copy of his/her medical records. However, each request must be submitted on the official Bone and Joint Clinic Records Request Form.

How To Request Your Records

Come to the Clinic

Patients can come into the clinic at any time during normal business hours, and records can usually be copied while you wait.  Just let our friendly front desk staff know that you would like a copy of your medical records.  They will have you fill out the request form and can assist you with any other needs you may have.

Mail, Fax, or E-mail

If it isn’t convenient for you to come to the clinic, you can print the request form and return it to the medical records department via mail, fax, or email.  If there is a deadline that you need the records by, please let us know so that we can make sure they are ready on time!


While most copies are provided free of charge, there are a few instances where you may incur a copy fee:

First Request

The first time you request your records, copies of any papers in your chart are provided free of charge.  If you would like a copy of your x-ray or MRI images, a $10 fee is incurred.

Subsequent Requests

Requests for copies of papers that have previously been furnished to you are subject to a per-page copy fee, as allowed by LA R.S. 40:1299.96.  These fees are as follows:

  • $1/page for the 1st 25 pages
  • $0.50/page for pages 26-350
  • $0.25/page for all pages thereafter
  • $10/CD for copies of imaging
  • $25 processing fee
  • Postage (if applicable)

In order to avoid copying fees, it is recommended that you maintain the originals given to you by the clinic and furnish only copies to others who may need them.