If you would like 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.