Request a Copy Of Your Records

You can request a copy of your hospital medical record to be sent to you or a designated recipient. A processing fee may be required. This copy can be requested in paper form or on a DVD.

Written Authorization Required

You will need to submit your request in writing to give us permission to copy your hospital medical record, or parts of your record, and forward it to you or another person or organization. Your original signature is checked against our records to validate the authenticity of your request.
 
You may use the Authorization for Release of Medical Information/Patient Access Form, which can be accessed in one of three ways:

• Download it: Authorization for Release of Medical Information/Patient Access Form. 
  • Download Spanish version 
• Have it mailed: Call the Medical Records/Health Information Management Services Department to request that the form be mailed to you.
• Visit the Medical Records Department: Stop by the Medical Records/Health Information Management Services Department during regular business hours. You will need to show a valid form of personal identification.

Who Can Request a Copy?

The following people are authorized to sign for the release of medical records:

• Patient (not the spouse)
• Parent (with some exceptions, for children under the age of 18)
• Legal guardian (proof of guardianship document must be provided)
• Power of attorney if the patient is unable to sign (legal documentation must be provided and must specify access to medical information)
• Representative of the estate for a deceased patient (legal documentation must be provided, including, but not limited to, a copy of the death certificate)