How to Apply for a Refund of Your Medical Records RequestThe ChartRequest platform requires consent to automatically charge for a medical records request. However, if you would like to request a refund, please complete the form below. Request Identification #* You can locate this identifier on your invoice. Stated Reason for Refund of Medical Records Request*Explain, in detail, the particulars behind your request for a refund. Your Name * First Name Last Name Email Address * Mailing Address for Check RefundsThis is not required if you paid for the medical records request by credit card. Address 1 Address 2 City State/Province Zip/Postal Code Country Request a Refund