Submit Your Request

If you are requesting medical records as a patient or their legally authorized representative, please follow these steps to submit your request

Request Process for Patients or Authorized Representatives

If you are an individual requesting your own medical records or an authorized representative (requesting records on behalf of a patient), please follow these steps to get started.

Step 1

Complete the Authorization Form

Download the Authorization Form, fill in all required fields, and sign it.

Step 2

Gather Required Identification

Patients: Provide a clear image of your government-issued photo ID.

Authorized Representatives: You must provide:

A clear image of your government-issued photo ID.
Proof of your legal authority to act on behalf of the patient (e.g., Power of Attorney, Guardianship documents, Court Order or any other legal document).
A copy of the patient’s ID is optional.

Step 3

Send Your Documents to Lexa Records

Submit a properly executed authorization along with supporting documents by:

We will reach back out to you if we need clarification or additional information.
For more help, check out our FAQs or call us at 817-421-4700

Terms & Conditions

By submitting a request, you agree to our Terms & Conditions and Privacy Policy.
Unauthorized access, use, or distribution of protected health information (PHI) is strictly prohibited and may be subject to penalties under HIPAA and applicable state law.