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KP Form No. 1Republic of the Philippines Province of Albay Municipality of Barangay OFFICE OF THE PUNONG BARANGAY (Date) NOTICE TO CONSTITUTE THE LUPON To All Barangay Members and All Other Persons.

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Download, complete, and email the authorization to disclose health information (PDF) to KPCOReleaseofInfo@kp.org. Fax the completed form to 303-404-4750.

You can request copies of your radiology digital images such as an X-ray or a mammogram by contacting your Kaiser Permanente clinic. Or, call the Kaiser Permanente Radiology or Imaging Center where you had service; imaging centers are listed below.

Members or patients have the right to request paper copies, electronic copies on DVD, or downloadable electronic copies from a secure web portal. Kaiser Permanente uses CIOX Health for medical record deliveries. Billing or delivery questions should be directed to CIOX at 1-866-420-7455.

Standard medical record request Download, complete, and email the authorization to disclose health information (PDF) to KPCOReleaseofInfo@kp.org. Fax the completed form to 303-404-4750.

Ask them to send your records to Kaiser Permanente Medical Records, 10220 SE Sunnyside Road, Clackamas, OR 97015 or fax to 877-849-4116 or via email to nw-med-rec@kp.org.

Some of your medical records are already available to you online anytime, anywhere with My Health Manager on kp.org. As a registered user, you can review, download, and save to your computer or print the following information: Immunization record. Downloadable Clinical Health Summary.

Complete and sign a Confidential Communications Request form, and Fax it to 855-524-5257. Contact Member Services at 503-813-2000 and ask for the form.

To request these records, fill out and initial all areas of the authorization for Kaiser Permanente to use/disclose protected health information (PHI) form (PDF) and a cost letter, if required. You can return this information by mail, fax, or in person at the the nearest Release of Information office.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232