Request for Patient’s Health Records

If you have had prior eye surgery or a complicated prior diagnosis (like glaucoma, not like a stye) please fill our this form & e-mail it to your prior eye doctor (preferably a MD or eye surgeon, not an OD or optometrist) & CC [email protected] & ask them to reply to ALL with your prior eye records attached so we have them when you come in.

You can thus track if they reply with your records or not, as we’re just CC’d—you’re the main person to reply to (because under Federal Law only you the patient can request records, we can’t do this ourselves).

Document to print

PDF Form Document

Emil Chynn, MD, MBA, FACS

ASK DR. CHYNN!

Get ONE question answered for FREE by our famous Harvard-trained surgeon who's been featured on Discovery Channel & CNN

Dr. Chynn graduated from Dartmouth + Columbia + Harvard + Emory + NYU & has been on ABC, NBC, CBS & in the NY Times & Wall St. Journal

He’s performed 40,000 LASIK, SMILE, PRK, LASEK, & ICLs. He’s the ONLY eye surgeon in the US who’s had both LASIK & LASEK himself, so knows the pluses & minuses of each!

Dr. Chynn specializes in treating cases which don’t qualify for LASIK, including:

• extreme prescriptions
• thin corneas
• astigmatism
• need for reading glasses

See other Real Patient Questions that Dr. Chynn has answered! Ask Dr Chynn 

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