Release of Medical Information - TO Dr. Wagner

It is not necessary to bring prior medical records to your visit.  After your exam, Dr. Wagner will ask for specific records if necessary.   

To have another provider to send records to Dr. Wagner, click below to print the release form.  

In order to expedite your request, please provide All information requested and sign and date. 
- For the fastest service, send the form directly to the Provider that holds your records.  
- If you prefer, you can send the form to us and we will send the form to the Provider that holds your records


Copyright © 2024 Laura Wagner, MD. All Rights Reserved.
14377 Woodlake Dr. #111 • Chesterfield, MO 63017