Jen -
Great responses from everyone - and I'll give you the other "perspective" as I've managed medical practices for years.
If you are changing because you have to - but really liked (loved) the practice/physician etc....it's nice to receive a card or note from a patient explaining why they have left and other positive feedback. You may not think that a physician will notice if you leave - but if you are one of the families that they have a good rapport with - they will miss you. On the other hand - if you liked the physician but had issues with the practice; staff etc....it is really beneficial to the manager/physician - to receive that info as well. They may not realize there are problems or that you had a concern - if you didn't let them know. If you didn't like the physician - just request your records and move on.
As far as your records go - it is a law that all requests for records are made in writing and signed by the parent of legal guardian - unless the patient is over 18 - then they must sign for themselves. You can go 2 ways with the request -
1) have them sent directly to the new physicians office. Sometimes the old practice will send them without charging you - as professional courtesy but by law - they are allowed to charge for the records.
2) request that they be sent to you - and you will bring them to the new practice - as each child needs to be seen. If you do this - make sure that you make an additional copy of each child's record - and keep it for yourself. Believe me when I tell you - it is possible for them to get lost - and it never hurts - to have them at hand. Also- don't take them all in at once - if only 1 child is being seen. Most practices will not make up a chart until a patient is actually being seen due to the cost of each chart, etc...therefore - they may keep them in a "new patient - unseen" file or folder - and again - they can get lost or they may purge them out and destroy them after a certain length of time - if the patient isn't seen.
Usually a practice will charge a patient for the records if they are going to the patient directly. However if you can afford it - then it is well worth the cost of having your own copy. If you had issues with the practice and were unhappy - then you may want to speak with the physician or manager directly - let them know why you are leaving and request that they waive the fees for sending the records on. It's been done as a way of trying to satisfy the patient. Also - most practices will tell you that it can take several weeks to get those copies - so plan ahead to get them. If you need something urgently - like immunization records - they may give that separately to you sooner.
Good luck -
P.