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Request Upload


We do not accept any records requests by fax, email, or personal service. You must upload your request for records from our Request Upload Module.

Patient Request

  • Reference Number. Enter a reference number. With this number you will be able to track your record request at any time, during the retrieval process.
  • Drag & Drop .PDF File. Drag your request file and drop it into the box or select browse to choose your file. Only ONE .PDF file per request will be processed.
  • Upload & Submit. All requests are subject to twenty business days turnaround. Please do not call during this period of time. We'll keep you posted on any further updates by fax and email.

Once your request is received, it will be processed based on your ATTACHMENT 3. An initial processing fee invoice will be submitted for all on all types of records requested.

Subpoenas for Personal Appearance must be personally served directly to the medical doctor, or to the most knowledgeable person who you are requesting to appear or testify at trial or hearing. Witness fees per the California Government Code §68092.5, must also be included and payable to the medical provider's name, at the time of service.

NonSurgical Medical Group

3801 S. Harbor Blvd Ste B

Santa Ana CA 92704

Our Clinic Locations

DO NOT serve our practice, our staff will not process your request.
Update your database, and serve your request for records from My ROI Portal. If you are unable to upload, mail your request for records to our Request Processing Center.

Request Processing Center Mail Only

Request Processing Center

1142 S. Diamond Bar Blvd 310

Diamond Bar, CA 91765

IT IS OUR POLICY THAT ANY OUT OF STATE SUBPOENA MUST BE ACCOMPANIED WITH A HIPAA AUTHORIZATION SIGNED BY OUR PATIENT.