Online Forms

Medical Records

If you require copies of your medical records, please download the form from the links below. Be sure to use the correct form, depending on whether you are asking for records to be sent TO RCIPS, or if you are asking to have records sent FROM RCIPS. If you are requesting records from RCIPS, return the completed form to our office. You can also request records through the Patient Portal.

Medical Record Release >>

Need to Send a Copy of Medical Records TO RCIPS?

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 >>

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