Records Request

Here you can view and download our request for medical records release form. Please complete the entire form to ensure a prompt reply.

Release of Records

Release of Medical Records Authorization Form

Please fax the completed request to: (603) 369-3017, or mail to:

Performance Health

Attn: Medical Records

91A North State Street

Concord, NH 03301


If you have any questions, please contact our office at (603) 724-2297.


  • Contact Us

    91A N. State Street
    Concord, NH 03301
    P: (603) 724-2297
    F: (603) 369-3017

    Request An Appointment