Patient resources

Medical record request

Complete the form below so we can locate your chart, verify identity when needed, and process the documents you request under PPSI privacy procedures.

Scroll to form How requests work

Private request process

Information you submit is used to process your request. We may call or email to verify identity or request a signed authorization.

Processing time

We work to fulfill requests promptly. Some cases require a signed authorization or additional review.

Need help now?

Call (732) 444-8888 for records help. Email mr@njnopain.com for general questions only; do not send DOB, symptoms, insurance IDs, or detailed health information by regular email unless instructed.

Request appointment

Request form

Fields marked with * are required. Be as specific as possible about dates and types of records (e.g. visit notes, imaging reports).

Not for emergencies. If you are experiencing a medical emergency, call 911. Requests may require identity verification or signed authorization, and submission does not guarantee immediate release. By submitting, you agree we may contact you about this request.

Your care team is here to help

Questions about the portal, past visits, or follow-up care? We’re one call away.

Call (732) 444-8888 Contact us