MEDICAL RECORDS

Requests for Medical Records and Completion of Forms/Paperwork: 

To request medical records and/or completion of paperwork/forms, click here to download the request form.

Fees for Medical Records/Completion of Forms

  1. Copy of progress notes of patient visit(s):  $5.00 per visit, $35 max
  2. CD of x-rays taken at Leelanau Foot and Ankle Center, P.C.:  $20.00 per CD
  3. Completion of FMLA paperwork:  $25.00 per form
  4. Completion of disability paperwork:  $25.00 per form
  5. Completion of parking placard paperwork:  $25.00 per form
  6. Completion of other form:  $25.00 per form

(The fee for service for these items is likely not covered by your insurance and will not be submitted to the insurance carrier for payment. You are responsible for the payment of these fees at the time of request.)

Payment is due at time of request. Once the full payment is received, please allow two to three weeks for completion of your request. If you need to request “Rush Processing” (available within 3 business days) an additional $25 will be charged. (This option may not always be available [for instance, if the doctor is out of town], so please confirm this with the Office Manager first.)

The completed authorization and request forms can be dropped off in person or mailed to our office along with the payment, or faxed 231-866-4408 to our office with a request to contact you to arrange payment via debit/credit card.

Forwarding Office Visit Notes to Other Physicians

Office visit notes are automatically sent to your primary care physician on record subsequent to each visit at no charge. For this reason, it is very important you notify us immediately if you change primary care physicians. You may also request these notes, free of charge, to be sent to other physicians in your circle of care (such as your cardiologist, endocrinologist, etc.) You may request this by downloading the request form and returning in person, by mail or fax (231-866-4408); or by submitting a request electronically through your Patient Portal. (From the Patient Portal menu, select "Message" > "Inbox" > "Compose".)

Online Access

You may view your electronic medical records online. Please click to complete the login process and follow the prompts as instructed.

Contact Us

Proper care of the feet and ankles is vital to the overall health of people of all ages, and Leelanau Foot & Ankle go the extra mile needed to make sure our community’s needs are served with family-friendly warmth, compassion, and top-notch medical talent. Use this form to ask about our foot & ankle services. For confidential questions, please call us directly at 231-866-4406.

Please do not submit any
Protected Health Information (PHI).

718 North St. Joseph Street
Unit K1
Suttons Bay, MI   49682

Phone: 231-866-4406

Office Hours

Monday: 8:30 am – 4:30 pm
Tuesday: by appointment only
Wednesday: 8:30 am – 4:30 pm
Thursday: 9:00 am – 6:00 pm
Friday: Closed
Saturday: 8:00 am – 12:00 pm (by appointment only)

To schedule an appointment, please call: (231) 866-4406