Information transfers are handled electronically. Requests for medical records are typically processed within 48 hours of the request.

Electronic Forms Requests

Please use the form below to request medical forms for your child. Please note the demographic fields listed below must match the information listed on your account.



Important Note:

Form requests will not be processed if patient has not been seen for a well care within the past 12 months.


In order to process your request you will need to set-up a secure account with "Reach my Doctor". Confidential Patient Information can only be exchanged using this account. Use the link below for detailed instructions on setting up a "Reach My Doctor" Account. Your medical forms will be sent via secure email to this account within 4-5 business days.

Download PDFReach My Doctor



Electronic Forms Request

Demographic Information
Your Name: :
Relationship To Child::

Street Address: :
City: :
State: :
Zip Code: :
Phone Number: :
Email :
Child 1
Child Name :
Date of Birth: :
Child 2
Child's Name :
Date of Birth: :
Child 3
Child's Name :
Date of Birth: :
Child 4
Child's Name :
Date of Birth: :

(Please include all children you are requesting records for);
Sports Forms:PSD Junior High Sports Form
PSD High School Sports Form
Thompson Valley Sports Form
Windsor Sports Form

(Please Check Your Request)
Medications:PSD Medication Release (Please Specify Medication Below)
PSD Medication Release for Asthma (Please Specify Medication Below)
PSD Medication Release for Allergy (Please Specify Medication Below)
Thompson Valley Medication Release (Please Specify Medication Below)
Windsor Medication Release (Please Specify Medication Below)

(Please Check Your Request and fill in Medication)
Specify Medications :
Please specify for forms above
General:Generic Health Form (Day Care, Camps, Parks and Recreation)
Over the Counter Daycare Medication Release (Diaper Cream, Tylenol, Advil, etc.)
Generic Medication Release
Consultation/Second Opinion
Personal Use
Legal
Insurance Request
Other

(Please Check Your Request)
Other:Other Health Form (attach next field)
Immunization Record

Other Health Form :
Upload downloaded or scanned form and attach
Other Comments:
Security:Enter the code exactly as you see it in the image:
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