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  • Providence Medical Records Release Form

Get Providence Medical Records Release Form

PROVIDENCE ST. MARY MEDICAL CENTER 401 W. Poplar, P.O. Box 1477 Walla Walla, WA 99362-0312 (509) 525-3320 FAX (509) 522-5776 Attachment to Policy 8690.1001 4/2012 Pick Up Mail AUTHORIZATION TO DISCLOSE.

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Contact the custodian of your health records, such as a doctor, clinic or hospital, to request access. The custodian might ask you to make a formal request, in writing. You can write a letter or use this Request to Access Personal Health Information Form.

Download Dot Health If you're a Canadian resident looking for health records from providers within Canada, you're in luck! Try downloading Dot Health. We strongly feel this is the most convenient way to access all of your health records, no matter where they're from.

There are three types of medical records commonly used by patients and doctors: Personal health record (PHR) Electronic medical record (EMR) Electronic health record (EHR)

To get a copy of your medical records Ask the doctor for a copy of your records. They may charge you a fee to copy them, as the Medical Services Plan does not pay for it. Doctors of BC sets approximate fees in its fee guide. Alternatively, you could ask to take a picture of the records with your phone.

You may also fax your request to 202-854-7931. If you have questions regarding release of medical records or need to check on the status of a request, please call 202-854-7000. If you choose not to transfer your records, they will be maintained in ance with Providence's medical record procedures.

You or anyone you have authorized to act on your behalf can request access to, or copies of your health records by completing the Authorization for the Release of Health Records form and submitting it in person, by fax, or by mail to the Health Record Department at the location where you received care.

Download Dot Health If you're a Canadian resident looking for health records from providers within Canada, you're in luck! Try downloading Dot Health. We strongly feel this is the most convenient way to access all of your health records, no matter where they're from.

If the record is requested by the patient for personal use, the physician or surgeon is entitled to collect the fee prior to providing the copy.

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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