LAURA EVANS, M.D.

Phone: (626) 605-3434
Email: dr.evans@lauraevansmd.com
3527 Ocean View Blvd. Glendale, CA 91208

How to Request Medical Records

Please complete the Form to Authorize Release of Health Information. Please complete the form in its entirety, including your signature. Signed requests for copies of medical records can be directed to:
Laura Evans, M.D.
466 Foothill Blvd. Box #115,
La Cañada California 91011

Form to Authorize Release of Health Information