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Medical Records Request


To obtain a copy of your medical records, please complete the form:

HIPAA Compliant Patient Authorization to Release Medical Records

Return the completed form one of three ways:


FAX: 985-951-7101

Louisiana Pain Specialists
C/O MedSouth
PO Box 1630
Mandeville, LA 70470

We will mail records to you directly based upon the address you provide on the form. In addition, you will receive an invoice reflecting a nominal fee to help cover expenses associated with processing your request.

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