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ADULT AND PEDIATRIC PATIENTS / MEDICAL DERMATOLOGY COSMETIC DERMATOLOGY / SKIN CANCER SURGERY Heidi K. Anderson MD Cathy Balestra MD Brad Kovach MD Monika Wrobel PA-C Jane Thomas RN Medical Records Request Please Circle TO / FROM Dermatology of Coastal Sarasota 5310 Clark Rd Suite 201 Sarasota FL 34233 Phone 941-925-3627 Med. records fax 866-405-4932 FROM / TO Physician Name Phone Fax Address City State Zip I hereby request and approve the release of my records Patient s Printed Name Patient...
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Adult patients are individuals who are 18 years of age or older, while pediatric patients are individuals who are younger than 18 years of age.
Healthcare providers and facilities are required to file information on adult and pediatric patients.
Healthcare providers and facilities can fill out information on adult and pediatric patients through electronic health records or paper forms.
The purpose of filing information on adult and pediatric patients is to keep track of their medical history, treatments, and outcomes.
Information such as demographics, medical history, treatments received, and outcomes must be reported on adult and pediatric patients.
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