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Pay for Your Medical Records Request

Fields marked with an asterisk are required and must be completed prior to clicking Pay Now.

This form is for paying for Medical Records requests. If you are paying for public records, please use the Public Records Request Form.
A valid email address is required. Upon successful completion of your payment you will receive a receipt via email.
Please enter your phone number in case we need to contact you regarding this transaction or your records request.
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IMPORTANT NOTICE: THIS IS NOT THE SITE TO MAKE DEPOSITS TO AN INMATE’S ACCOUNT OR TO PAY COMMUNITY CORRECTIONS FEES. TO MAKE THESE PAYMENTS, PLEASE VISIT: corrections.az.gov/electronic-payments

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