To request medical records please download and print the medical release form.

Return the form by doing one of the following:

• in person at 10631 S. 51st Street, Suite 8, Phoenix AZ 85044
• Fax to 480-398-4281
• email completed form to office.staff@pillerchilddevelopment.com

Releasing of medical records costs:

• First 10 pages are free/ calendar year
• Records over 10 pages costs $15.00 + .10/ page over 10 pages
• Records can be picked up in person (with identification) or mailed *certified mail.
• *Records mailed will be charged certified mail postage in addition to any processing fees.