Medical Records Request

Although you can view and print your medical records online via our patient portal, AGA requires written authorization in order to release these records directly to you or a third party via fax, email or in paper format.

This process is in place to protect your private health information. To request your medical records, please follow the below steps:

  1. Download and print AGA’s Medical Records Release form.
  2. Make sure the patient or authorized requestor (if not the patient) signs the form
  3. Submit your completed Medical Records Release form along with a copy of the requestor’s photo ID via one of the below methods:

– Fax or mail the form and copy of photo ID to any office location
– Email the form and copy of photo ID to
– Pick up records in person at any location by bringing the completed form and a photo ID