To transfer your medical record from a previous clinic to Adelaide Health Care, please fill out and sign this form. Once completed and signed by the patient, it can either be posted, faxed or dropped off to reception at Adelaide Health Care to commence the process. Alternatively, you can send the form directly to your former Practice. If you have moved to a new Practice and require your notes to be transferred from Adelaide Health Care, please contact your new Practice to sign an authority form. At Adelaide Health Care we can print a health summary for you at no cost, however if you require your complete medical record to be transferred, there will be a fee of $25 to cover our administration costs for this process.