Medical Records Request
How to Submit Your Request Form
All requests must come with a copy of an official photo ID (typically a driver’s license).
Email: Please send your request along with a copy of your photo ID to: info@achancetochange.org
Fax: 405-840-9017
US Mail:
Mail your request, and a copy of an official photo ID, to:
A Chance to Change
Attn: Medical Records
2113 W. Britton Rd.
Oklahoma City, OK 73120In-person:
You can complete a request with one of our front desk personnel at our facility
Typed signatures will not be accepted. All requests must be physically signed.