Records Request – NEW

Continue to provide wonderful services to your customers!
—Mobile Health Patient

You may request medical records via this online form. You must complete all required fields and make payment after clicking on the Buy Now button at the bottom of the form.

Mobile Health will mail medical records to the address entered on this form. Please specify one of the following processing options:

  • Processed and mailed within 10-15 business days. ($5)
  • Processed and mailed within 5 to 7 business days. ($15)

You may still request medical records via U.S. mail. Click for instructions.
If you have questions about your medical record request, please contact Mobile Health directly.

Please complete all required(*) fields below to request a copy of your medical record:



  • Date Format: MM slash DD slash YYYY
  • Delivered in number of business days
  • American Express