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Our records regarding the patient’s health will be kept by our office. We will release copies of medical records only if a Transfer of Release is filled out by the parent or legal custodian. If transferring records to another physician, you must complete an Authorization for Release form and mail or fax to our office. We have 30 days to complete your request, however, we will try to fulfill your request as soon as possible. Kentucky State Law requires that one copy of your records be provided free of charge. If further copies are requested, a fee of $1 per page will be charged.


Please send the Transfer Release to 3050 Harrodsburg Road Lexington, KY 40503 or you can fax it to 859-977-0237 or if you prefer you can email it to


Transfer Release

Transfer of Care/Release of Medical Information


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Pediatrician - Lexington
3050 Harrodsburg Rd
Suite 100
Lexington, KY 40503
(859) 277-6102

(859) 977-3033 Fax

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