Polaris Spine & Neurosurgery Center

Step #1.

Patients requesting their own medical records:

  • Download and complete medical record request form by clicking on blue button below
  • Complete form and use green upload button at the bottom of this page to send
Click to Download Polaris Spine & Neurosurgery Center's Medical Record Authorization Form

Step #2.

  • Upload the completed patient medical record request form by clicking the green button below
  • Enter your email, name and doctor's office name (Company) on the document repository page, then click "Continue"
  • Drag or select your completed Patient Authorization form to the document upload icon in the center of the repository page
  • Once you see the document's file name listed, click the "Upload" button.
  • Third party requestors use the green "Upload" button to upload your HIPAA compliant request and Authorization

If you have any document uploading issues, please call (800) 490-5007
and leave a message to request a call back for assistance.

Click to Securely Upload Your Medical Request Document