MED RECORDS RELEASE

Your medical record is strictly private. We will not give out information regarding your condition to your friends, relatives or employers without your permission.   The only exception is when required by law to do so.

If you would like a copy of your medical record from Beatrice Keller Clinic, please click the button below, fill out the form, print it out and mail it to the office where you see your doctor.

Authorization Form

 

Peoria: 13943 N. 91st Ave, Bldg C # 101
Peoria, AZ 85381

Sun City West: 14506 W. Granite Valley Drive, Suite #124
Sun City West, AZ 85375

Goodyear: 14537 W. Indian School Road, Suite #700
Goodyear, AZ 85338