Request medical records

Download, print and complete the Patient Access Request form click here for English, click here for Spanish and return it to Health Information Management. There may be a charge for these copies.

If you are a third party, such as an insurance company, workers’ compensation carrier, disability agency, attorney, etc., fill out and return the Patient Authorization for Disclosure of Health Information form. Click here for English, click here for Spanish.

If you are a healthcare provider, please complete this Continuation of Care request form.

To obtain a copy of a deceased patient’s medical record:

• The executor or administrator of the estate must complete, date, sign and return the Patient Access Request form linked above. A copy of the will or court order must accompany the completed form. A copy of the death certificate also must accompany the form.
• If you are requesting a deceased patient’s records for purposes other than settling personal or financial affairs of the decedent, contact Health Information Management. Please see the Contact Us information below.