Medical Record Request

In order to access your medical records you must fill out the DENT  Release of Information Form. If you click on “Medical Record Request Form” you will be able to download and print out the DENT Release of Information Form. Instructions are listed on the top of the ROI form that state the fax number and or address that you may mail your ROI request to, as well as time frame guidelines to process your request.

If you have any questions please call 716-250-2000 and ask to speak to a member of our Medical Records Department.

Medical Record Request Form

Request to Amend Patient Records

Call Us (716) 250-2000