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Desert Valley Dermatology Logo
  • Make A Payment
  • Patient Portal
  • About Us
  • Providers
  • Conditions
    • Skin Conditions
    • Skin Infections Treated
    • Skin Cancer
    • Benign Skin Tumors
    • Hair Disorders
    • Nail Diseases
  • Services
    • Medical Dermatology
    • Surgical Dermatology
    • Skin Cancer Treatment & Prevention
      • Skin Biopsy
    • Skin Care
  • Patient Information
    • Accepted Insurances
    • FAQs
    • Post-Treatment Care
    • Medical Records Release Form
  • For Referrals
  • Contact Us

Medical Records Release Form

Medical Records Release Form

Please download and fill out the PDF form below and email to us at [email protected].

This form can also be faxed to us at 602.835.2698

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Download Medical Records Release Form

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Desert Valley Dermatology

3815 E Bell Rd. Ste 3100
Phoenix, AZ 85032

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480.916.3376

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[email protected]

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Hours

Monday - Friday:
8:00am - 5:00pm

Medical Dermatology

Surgical Dermatology

Skin Cancer Treatment & Prevention

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