Patient resources

Medical Records Release Form will be used if Chapala Med is coordinating your care or referring you to another physician who may need access to your medical records.

All medical records are in EMR (ELECTRONIC MEDICAL RECORD) format that you will be able to have online access to and our records are compliant to U.S. HIPPA LAWS and are not share with anybody who does not have a clear criminal record with Mexican or U.S./Canadian authorities. This is done in order to protect your private confidential information from identity theft or fraud.

New Patient Intake Form (Download)

Chapala Med Forms (English)


Request an appointment


For our patients who prefer to pay fees and honoraries by Credit Card, we offer you the ONLINE PAYPAL PAYMENT OPTION.