Patient History Request Form
Complete the form below to request your treatment history from Louw & Swart Physiotherapy.
For your safety and confidentiality, all requests are verified before release. Please note that records can only be shared with the patient, or an authorised representative, and may take up to 5 working days to process.
By submitting this form, you acknowledge that your personal information will be used solely to process your request, in accordance with POPIA and HPCSA confidentiality guidelines.
We respect your privacy. Before submitting, please take a moment to read our Privacy Policy to understand how we protect and manage your personal information.
