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Request Medical Record

Medical Record Privacy Condition

You must agree to the following conditions to request the Medical Records. The below form is applicable to INPATIENT admission only. Click on one of the three topics below for more information. If you require assistance, please contact the Medical Records Department
at 800 262 392.

Medical records are considered highly confidential because of the very private, personal information they contain. You have the right to access your own medical information and can control who else is able to access it. With some exceptions, health care providers will release a copy to you and your authorized representative

Myself

Others

Medical Record Details

Upload File

Copy Of Medical Records For

Visit Dates

How Would You Like to Receive the Report?

If You Are Not Picking Up The Medical Records In Person, You Must Upload The Following Files:
Attach a copy of patient’s ID (.jpg,.pdf, .doc, .docx – less than 10 MB in size):

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