Request Medical Records

If you would like to request a copy of your medical records, please download and fill out the form below:

Click here to download Request Form

Completed forms can be submitted by e-mail or fax to Medical Records:

E-mail: josie@lascolinaspa.com

Fax: 909-458-0959 (Attn: Medical Records)

Thank you!

Get In Touch

Call

(909) 984-8629

Address

800 E 5th Street,
Ontario, CA 91764

Fax

888-619-8383