Request for medical records
We provide timely and secure access to your personal health information.
To obtain a copy of your or a family member's medical records, we ask that you complete the following steps:
1. Print the AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION form.
2. Complete the form and provide a valid signature.
3. Send completed form to firstname.lastname@example.org
4. Your signature must appear on the form to be considered valid. Electronic signatures or Adobe-generated signatures are not accepted.
Medical records are mailed, not faxed, no later than 30 days from the date that the signed request is received.
To amend or correct your or your family members medical records, visit this page.