Medical Records

Request a Copy of Your Medical Record

Requests Must be Made in Writing

1. If you would like to request a copy of your medical records for yourself, please use this request form in English or Spanish
2. If you need a copy to be sent to a physician’s office or other third party, please use this form in English or Spanish
3. Print a copy of the form, fill it out and return to the Medical Records Department in person (see address below)
4. To protect the privacy and confidentiality of your records, the Medical Records Department will verify your identity by requesting photo identification, a signature, or by asking pertinent questions
5. Our department has 30 days to respond to your request and make your records available to you.

If you have any questions please call (602) 406-3350.