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Blue Cross Blue Shield

Release of Medical Records

If you are transferring your care from a Kelsey-Seybold physician to another physician/provider in the community, that physician/provider can request a transfer of your medical record at no charge.
Optionally, you can call our Medical Records Department at 713-442-5700 and complete an Authorization for Release of Healthcare Information. You may also download a copy of the form here​.​
When you complete and sign the form and return it to Kelsey-Seybold, you authorize the release of your medical records to the community care provider of your choice. You may return the form in two ways:
  1. By faxing it to 713-442-5732.
  2. By mailing it to:

    Kelsey-Seybold Clinic - Meyerland Plaza
    Attn: Release of Information Department
    560 Meyerland Plaza Mall
    Houston, TX 77096.​​