PromptServe Family Medicine​​​​​​​

"Quality Care Prompt Service"


Records Release Form

Please use the below link to access the records release form. There will be a labor fee of $20.00 for the first 10 pages, $0.50 per page for pages 11-50 and $0.25 per page for pages 51 and higher to cover copy and transmittal costs.  Please note, there will be no fee charged from PromptServe Family Medicine if you or another medical provider requests your records to be sent to a medical provider's office.  Between April 16, 2018 and April 30, 2018 you may pick up your records between the hours of 8:00 a.m. to noon.  A copy of a valid photo identification will be required for all records release transactions.

After April 30, 2018 your records will be held with Clary Document Management, Inc.  Please complete the Clary medical records request form and submit the form along with a clear copy of your identification to Clary Document Management, Inc.  5600 Pioneer Creek Drive Minneapolis, Minnesota 55428. A copy of the Clary Document Management medical release form may be found here or by calling Clary at (763) 548.1320.  For any fee(s) associated with copy, retrieval, postage, etc. from Clary Document Management, please contact them directly.

Our clinic strives to provide a high standard

All of the staff here at PromptServe Family Medicine LLC strive to provide a high standard of medical care to all of our patients.  Please feel free to walk-in and experience the difference in a practice that truly believes in prompt quality care!


Billing Questions

Billing questions?  Please feel free to contact us using the link below or by calling 765-352-8082. We will return your message within 24 business hours.

Pay Online

Do you need to pay your invoice? Save the postage and envelope cost.  Simply click below and pay your bill online today!

Payment Credit

PromptServe Family Medicine LLC accepts Visa, MasterCard, American Express, Discover and Apple Pay.  To pay by credit or debit click below. 

HELP Program

If you are unable to make your entire payment please feel free to contact our office to be set up on a payment plan.  We will work with each individual need.



Confidentiality is one of the core duties of our medical practice. It requires our health care providers to keep a patient’s personal health information private unless consent to release the information is provided by the patient. For more information please contact a member of our staff. For our privacy policy please click below.


At PromptServe Family Medicine LLC we are concerned about your privacy and confidential information.  We abide by HIPAA regulations, and we strive to maintain accurate and confidential records on all of our patients. We take HIPAA and HITECH seriously and abide by all standards.

Records Requests

It is the policy of PromptServe Family Medicine LLC to receive an official records request form from our patients when medical information is being release.   For a medical records request form please click below.  Only original patient signatures will be accepted either in person, via fax, or US Mail.


The facilities at PromptServe Family Medicine LLC are non-smoking sites as we have adopted non-tobacco use policies for the health and safety of our patients.  Should you have any questions concerning our policy please feel free to contact any staff member. 


Our staff’s belief is that all our patients deserve our total commitment to achieving quality health for life. We strive to acquire the latest equipment and keep up-to-date with continuing education. Honesty and integrity are fundamental aspects of our practice here at PromptServe Family Medicine LLC.  We welcome your visit and hope you will see why PromptServe Family Medicine LLC truly is one of the best medical facilities in Indiana.

We will try to inform you of any medical issues that we see and explain all treatment options to you, along with estimated costs and individualize care by listening to your needs.  Our staff wants to be recognized in our community as the finest quality patient-centered practice in Martinsville. We pride ourselves on our service and we will answer any questions you have with respect and a smile, as we are a family who work together in an enjoyable and welcoming environment.