Records Release Form

At Olansky Dermatology & Aesthetics, we make it easy for you to request copies of your medical records. Whether you’re transferring care, coordinating with another provider, or simply need your records for personal use, our secure request process ensures your information is handled with care and confidentiality.

Authorization for Use and Disclosure of Information

Please complete the form below to authorize the release of your medical records. If you have any questions or need assistance, feel free to contact our office.