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For patients new to El Camino Pediatrics
Request For Transfer Of Records
From: Previous Doctors Office
To: El Camino Pediatrics
Patients being seen for the first time in our office should provide
our physicians with a copy of their child's medical records. These
could be brought in with you on your first visit or requested
to be sent to our office.
1. Click to select
medical record transfer form web pdf
2. Print Form
3. Fill out and mail or deliver to your
child's previous doctor
*Important:
Original signatures are required, so faxed copies will
not suffice.
Other Forms:
Click here to see other forms for New
Patients
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Medical Records