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7111 E. 21st Street
Wichita, KS 67206
(316) 684-2851
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Primary Care Associates
Medical Release Policy


  • It is the policy of Primary Care Associates to charge for requested copies of a consumer's medical records. A reasonable fee may include actual costs for copying, labor, mailing, shipping, or delivery.
  • Primary Care Associates may request that the fee be paid prior to release of the information for non-treatment or non-emergent purposes. Copies of records from other health care practitioners contained in Primary Care Associates records may also be made and given upon request. However, we cannot authenticate other providers' copies we have in our possession. A written release is required prior to releasing any records.
  • Primary Care Associates may charge the following:        
    1. Lawyers, court reporters
    2. Insurance companies for reason other than payment purposes
    3. Social Security Administration, SSI
    4. Patients or their legally authorized representative for personal purposes such as copies to take to another provider, hospital, nursing home, home health agency or school, etc.
    5. Records related to Workers Compensation cases according to the following fee schedule implemented by the State of Kansas Division of Workers Compensation effective December 1, 2001.
  • We will not charge a patient for their records when records are sent directly to another doctor, a VA office, a military facility or when the patient is leaving the country.
  • Charges for copies of records will be as follows:
  • Dictated Report  $30 fee
  • Medical Records $18 fee
  • No Charge for pages between 1-10
  • $.60 per page for the first 11-250 pages
  • $.40 per page after first 250 plus pages
  • $20 for radiology CD's
Medical Record Release
Medical Record Release Form
Copyright 2005 Primary Care Associates
Webmaster Julie Brost