Request Your Dental Records

We'll help you get your complete dental records quickly and professionally. The process takes 3-5 business days, and we'll deliver everything securely via email.

Complete Records

All X-rays, notes & history

Processing Time

3-5 business days

Secure Delivery

Via Email or in-person

Administrative Processing Fee: $75.00

Your records are yours at no charge. This fee covers only the administrative work to compile and deliver them securely.

What the fee includes:

  • Staff time to compile and verify records
  • HIPAA-compliant secure delivery system
  • Quality assurance review
  • Technical support if needed

Permitted by California law and ADA guidelines.

Get Started

Complete the form below and authorize payment. We'll review your request and process your records within 3-5 business days.

Patient Information

We'll send your records to this email

Identity & Authorization Verification

I am requesting records for:

Security Verification

To protect patient privacy, please provide the following for the PATIENT (not the requester):

Understanding why you need your records helps us serve you better

Records Delivery

Professional Transfer (Optional - No Additional Fee):

Payment Authorization

If the person paying is different from the patient (e.g., parent paying for child), enter the cardholder's name here.

Loading payment form...

Authorization

Your payment will be authorized and your request will be submitted. Staff will review and process your request within 3-5 business days.

Frequently Asked Questions