Online Forms

Medical Records

New and returning patients often need to have certain medical records sent to our office to assist in their diagnosis and treatment.  If you need your current (or previous) provider to send your records to RCIPS, a request form may be obtained at the clinic, or through this link:

Medical Record Release to RCIPS >>

If you require copies of your medical records, please download the form from the link below. If you are requesting records from RCIPS, return the completed form to our office. 

Medical Record Release >>

Records can be mailed to:

River Cities Interventional Pain Specialists
Attn: Medical Records
8731 Park Plaza Drive
Shreveport, LA 71105

To schedule an appointment

Call 318-797-5848 or