RECORDS/BILLS REQUEST

You can now request records and bills directly from our website. Please use the following submission form. Please make sure you attach the required medical release of information signed by your client.

Schedule Appointment





Request records/bills for your clients using this easy online form

RECORDS/BILLS REQUEST


    All Fields Required

    Patient Name

    Patient Date of Birth

    Upload your files here or email to records@gorenewhealth.com

    Requesting Office Name

    Requesting Office Phone

    Have a new client you’d like us to see? refer them now!

    SEND US YOUR REFERRAL


      All Fields Required

      Patient Name

      Patient Date of Birth

      Patient Phone Number

      Reason for Referral?

      Referring Office Name

      Referring Office Phone Number






      Renew Health

      A practice focused on the diagnosis and treatment of patients involved in trauma that result in pain syndromes, orthopedic injuries, and/or neurological injuries.


      CONTACT US NOW

      480-681-7979




      Schedule An Appointment



      Follow Us

      Stay connected with Renew Health!



      Copyright by RenewHealth 2021. All rights reserved.