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Dr. Shahira Boulos

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Dr. Shahira Boulos

490 Harry Walker Parkway S., Newmarket, ON L3Y 0B3

After much soul searching and reflection, effective February 1st, 2017, I have decided to close my family medical practice and move on to a new path for the latter years of my career.

Needless to say this has been a very difficult decision for me. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent tempus aliquam dolor, eget congue sapien tristique ac. Proin accumsan leo sit amet interdum ornare. Aenean pretium a arcu vitae malesuada. Aenean consectetur, orci vulputate pretium maximus, metus odio lacinia neque, ac vulputate nibh arcu vitae neque.

To ensure continued care with your next healthcare provider I strongly recommend that you get a copy of your medical record. In accordance with regulation, I have contracted with RSRS (Record Storage & Retrieval Services), a compliant medical records facility, to store the records from my practice and to transfer a copy of your file upon your authorized instruction. To obtain a copy of your medical record, follow the instructions and fill out the form below to complete an online request.

MEDICAL RECORD REQUEST FORM

  •      (Someone outside your family? Click here.)
     

  • Request additional records:

    Please list any additional family members for whom you are requesting medical records. Include Date of Birth for each as well as the date when each last saw the doctor.
  • First nameLast nameDate of BirthDate Last Saw Doctor 
    Add a new row
  • For emergency matters only. If you select this option, immediately call 1-888-563-3732, Ext. 205 and leave a message explaining your extraordinary circumstances and timeline.
Note:

  • A Release of Information Form must be completed and signed prior to the release of any medical information. If you do not have one, RSRS will supply you with one.
  • You are entitled to a COPY of your patient record. An original paper record is the property of the physician and must be retained in storage for a period of time, after which it is shredded.
  • Each patient of legal age or older must sign for the release of his/her own record.
  • There is a fee for the transfer of medical information. The fee is set in accordance with guidelines. The fee is not prohibitive and records are not withheld once properly authorized for release.

If you have any problems using this form or if you have questions, please contact RSRS by telephone at 1‑888‑563‑3732, Ext 1 or email info@rsrs.com.