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NEWBORN FORM
MEDICAL RECORDS REQUEST

Please use this form to request a medical record transfer from your current pediatrician to our office. We advise that you do not request for a transfer unless you have an appointment scheduled with us already to prevent potential gap in care.

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***If you were a previous Dr. Ramos patient and have not requested your records to be transferred elsewhere, please complete the same form and email to jrowan@savintegrativepeds.com

 

If you have a physical copy of your records, you may bring them to our office.

NEW PATIENT PACKET
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