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Transfer of Care:

Updated 10/13/2020

Transfer of Care from Pediatric Endocrinology of Rhode Island

Instructions for Transfer of Care from Pediatric Endocrinology of Rhode Island

Please complete the form, Release Records Authorization (for Release of Information) printable from the tab at the left. Send to our office by ONLY fax (401-434-0523) or portal.

We cannot release any records until we receive this fully completed form. Please do NOT email or text this form. We have extended the deadline for the Release Form. Our office must receive the release no later than October 28, 2020.

Please note that, we are unable to provide entire records at this time. The website will be updated on October 30, 2020 with a link to a medical records company who will be able to provide you with your entire chart.

After every visit at Pediatric Endocrinology of Rhode Island, your primary care doctor was sent a copy of each visit note with any labs. You do not need to sign a release to send records to the primary care doctor we have on file. Please have your doctor’s office contact us if they believe they are missing any records.

To ensure a safe transition of care, we will fax a limited chart containing the last 2 office notes, the last year of lab or imaging results and growth charts to any physician of your choosing.

To the left of this page, we have included a link to a list of Pediatric and Adult Diabetes and Endocrine centers in the area who are accepting our patients. We have not included individual doctor names nor any specific recommendations.

All record release requests will be completed by our office by October 28, 2020. Given the volume of patients requiring records to be sent, we cannot individually confirm receipt of the records by the receiving offices.


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