Dear Patient:
Effective 8/31/2024, I will be closing my practice at 5606 S.W. Lee Blvd. #302, Lawton, OK 73505. Beginning 9/1/2024, I will become an employee of Norman Regional Health System and relocate my practice to Norman Regional Moore, 700 S. Telephone Rd., Moore, OK 73160.
If you would like to continue seeing me in Moore after 9/1/2024, you may call 405-307-5700 to schedule.
Below is in an authorization for release of you medical records to another physician of your choice. Please complete the form, sign it, and return it to my office. I can then forward you medical record to the physician of your choice. Should you need access to your records after 9/1/2024, please contact us at 580-699-8412.
When selecting a new physician, please remember to take into consideration your medical insurance or health care plan and make sure your new physician is a provider under your coverage.
Please contact our office at 580-699-8412 at your earliest convenience to ensure prompt attention to prescription refills, scheduling of appointments, or transfer of records. It has been my honor to serve as your physician.
Yours truly,
Geetha Bhavani Kandimala MD
Medical Records Request
Oklahoma Standard Authorization (pdf)
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