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doctors & locations MyChart
Urgent Care

Reliant Medical Group Southboro Medical - Now a part of Reliant Medical Group Phone number for Reliant Medical Group: (800) 283-2556 Phone number for Southboro Medical Group: (508) 481-5500

Medical Records Release Authorization Form

This form will allow patients to authorize copies of their medical information to be released to person/ facility named. For Frequently Asked Questions about obtaining a copy of your medical records, click here.

You may also request your records through your MyChart account.

Please send completed form to:

Reliant Medical Group
385 Grove Street, Worcester, MA 01605
(508) 721-1142 • Fax: (508) 453-8030
Email: release@reliantmedicalgroup.org

Southboro Medical Group
24 Newton Street, Southborough, MA 01772
(508) 460-3015 • Fax: (508) 460-3143
Southboro Medical Group
Email: smgrelease@southboromedical.com