Patients & Requestors Thank you for contacting DataFile Technologies. Please complete the form below and we’ll respond to your inquiry as soon as possible. Have you submitted a request for a medical record to the appropriate provider?* Yes No Tell us about youAre you a patient or a third party requester?* Patient Third party requester Other PLEASE SELECT ONLY ONE OPTIONYour Organization*Your NamePatient Name*Your Email Address* Enter Email Confirm Email Your Phone NumberTell us about your requestWhen did you submit your request? MM DD YYYY If you do not know the original date of your request, please leave this field blank. Invoice number, if applicable:If you do not have an invoice number, please leave this field blank.Facility (Medical Practice) where care was provided:*Where did you originally send the request?What status question can we answer for you?*