Appletree can provide you with a copy of your medical records included in your patient’s chart. A Medical Release Form must be signed by the patient (if 16 years of age and older), by the parent/guardian (if the patient is 15 years of age and under) or by the power of attorney (person given full legal permission with a signed document from a lawyer to make decisions on behalf of the patient) to request medical chart information. You can visit the Patient Resources section of our website to print, complete and mail or fax the Medical Release Form. Complete details are included in the actual form. Note that there is a $45 fee for Chart Transfers.