Your Health Information
Request Your Medical
Records
Need a copy of your records? Request them securely in minutes. Click the link that applies to you.
Click the link that applies to you and start a new request.
Verify your identity with a photo of yourself holding your government-issued photo ID.
Receive text or email updates. Records are typically ready in 5-10 business days.
Mobile/Cell Phone
Upload Requirement
When uploading from a cell phone, Screen Rotation (Auto-Rotate) must be enabled. If this setting is turned off, your upload may fail or images may not display correctly. Please enable Screen Rotation before starting your upload.
Questions? Call (866) 992-7001
Medical Form Completion
FMLA, Disability & Other
Forms
For FMLA, Disability, Work Accommodation, and other forms, submitted and completed securely through Verisma.
How it works: Click, accept the agreements, enter your info, upload your photo ID and the blank form, pre-pay the fee, and submit. Standard turn-around is 5-7 business days.
Per-Form Fees
Pre-payment required before processing. No form fees for Workers’ Compensation forms or patients with Medicaid coverage verification first.
Questions? allyforms@verisma.com