The medical records of any Cooper Clinic patient are shared by all Cooper Clinic physicians. If you wish to transfer your medical records to a non-Cooper Clinic physician, a completed and signed Release of Information Form is required.
Photo Courtesy of Times Record
The Release of Information form is available at any Cooper Clinic location or click here to print a copy. When the form has been completed, you may:
- Submit at any Cooper Clinic location
- Mail it to:
Cooper Clinic, P.A.
Attn: Release of Information
6801 Rogers Avenue
Fort Smith, AR 72903
Cooper Clinic cannot FAX your medical records to any entity except another healthcare facility.
Please take note of these important policies regarding your medical records:
- Cooper Clinic cannot FAX your medical records to any entity except another healthcare facility.
- There is no charge for copying and transferring Cooper Clinic medical records directly to a non-Cooper Clinic physician.
- The charge for releasing medical records directly to a patient is as follows:
50¢ per page for the first 25 pages, then 25¢ per page thereafter. Shipping and handling charges may apply.
- Please allow 5-7 business days for your request to be processed.
If you have any questions or need assistance completing the Release of Information form, please call Release of Information at 479-274-2640 or 1-800-333-1305.