MEDICAL RECORDS REQUEST
NDBC wants to make requesting your records for yourself or another provider as easy as possible. Please fill out the form below and NDBC will email you an electronic link to fill out the info of where you would like your records to go to and then sign off.
Please allow up to 3 business days for this to be processed by our staff.
IMPORTANT:
Please input your information carefully… If your below information does NOT MATCH EXACTLY what NDBC has on file in your account, we cannot complete your records request electronically and an NDBC member will need to reach out to you to try and verify your account.
If they cannot verify your account information, we can either then mail an authorization form to you, or you will have to stop into an NDBC clinic and complete the authorization form.