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Richard M. Levin, M.D., PSC. Phone: 502-584-7787 | Fax: 502-589-3842 E-mail:

Obtaining your records


Computer users who have a printer click the button below.  Fill in every field including the current date.  Sign the form and mail it to the Medical Records Department of the facility where your had your sterilization procedure or to the doctor's office who performed your procedure.  Once we receive the records we will send you an e-mail letting you know what we thing about those records.

Cell phone or tablet users:  You will need to find a computer with a printer to use at the Free Public Library, at work or a friend's house.  Once you find such a computer then come back to this page to send for your records.  You could also call the facility where you had your tubal and ask for them to mail you a "Records Release Form.

Computer Users