Records Release Form

If you are new to us or leaving us at Vibrant Kids Pediatrics, you may use the following records release form to request that your prior pediatrician’s office send your child(ren)’s medical records to us or for us to send the medical records to your new pediatrician’s office. Please return the completed form(s) to your prior or new pediatrician’s office, or to us, and we will forward it or the medical records to their office.


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