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Stop Payment

Stopping payment on your medical records request?

Stop Payment

At ChartRequest, we’re committed to delivering medical records at blazing-fast turnaround times. But—if you paid for medical records by check—we understand that snail mail can delay your payment.

If your check didn’t arrive in a timely manner, complete this form before you stop payment. Otherwise, per our Terms of Service, there will be fees incurred.

If you don’t fill out this form, we will assume that you decided not to pay for your medical records, and we will have to charge a penalty—or place a freeze on your account.