Comprehensive Epilepsy Center
Other Requests
Medical Records
The medical record is confidential and will not be copied without written consent from you. If you need a copy of your records,
please contact our staff for assistance.
Forms
We receive many requests for completion of forms, letters for school, work or to insurance companies. Please give us as much
advance notice as possible for these requests. We are unable to fulfill these requests on a same day basis and ask for your
patience due to the large volume of requests we receive.
* Effective Monday, February 24, 2003, there will be a charge of $10.00 for the completion of all forms related to your care
in the Jefferson Epilepsy Center. Payment (cash or check) is required in advance of the form being completed and released
from this office.
If you have any questions, please contact Lisa Bratek at 215-955-4624."
