Accessibility Tools

Medical Record Requests

Tri-Valley Orthopedic Specialists respects the health information rights for our patients and has partnered with Provider1st to securely provide medical records to patients, guardian/legal representatives or 3rd party requestors with authorization. Please use the online portal below to submit your medical record requests with proper authorization.

You can also request Medical Records by Email: (requests@provider1st.com) or Fax: (800- 818-2114) with proper authorization information. If you have any questions or would like to check record status you can reach Provider1st by phone at: 855-514-2378

Request Medical Records

Patient MRI Acknowledgement

Authorization for Release of Medical Information

DR. LIU – Initial Comprehensive Pain Questionnaire

Dr. Long – Spine Patient Questionnaire

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