Get Requesting Medical Records To Request A Copy Of Your Medical ...

This guide provides users with detailed instructions on how to effectively fill out the Requesting Medical Records form online. By following these steps, individuals can ensure their medical records requests are completed accurately and efficiently.

Follow the steps to complete your medical records request form online:

1. Press the ‘Get Form’ button to obtain the Requesting Medical Records form and open it in your web browser.
2. Begin filling out the form by entering your full name in the designated field for 'Patient Name'. This information is crucial for identifying the medical records you are requesting.
3. Provide your contact phone number in the 'Phone #' field to facilitate communication regarding your request.
4. Fill in your date of birth in the 'Date of Birth' field to verify your identity in connection with the medical records.
5. Enter your Medical Record Number (MRN) if available, as this assists the healthcare provider in locating your records more efficiently.
6. Complete your current address in the ‘Address’ field, ensuring it is accurate to receive any correspondence.
7. In the 'Requested Records' section, choose whether you want records from 'All TMC HealthCare' or 'Tucson Medical Center'. Tick the appropriate box.
8. Select the timeframe for which you wish to receive records, either 'All past, present, and future periods', or specify a defined date range by filling in the start and end dates.
9. In the specific description section, check all applicable types of records you are requesting, such as 'Complete Record', 'Billing/Payment', 'Lab Results', etc.
10. Indicate if you require information pertaining to sensitive topics, such as 'Mental Health' or 'Communicable Diseases', by checking the relevant boxes.
11. State the purpose of your record request by checking the appropriate categories identified in the 'Purpose of Record Request' section.
12. Specify the recipient of the records by marking whether it is for yourself, a third party, or another individual.
13. Choose the form and format for how you would like to receive the records, such as through MyChart, encrypted email, unencrypted email, by mail, or other methods.
14. If you choose unencrypted email, read and acknowledge the terms by providing your initials in the designated field.
15. If opting for mail delivery, provide the mailing address for delivery of the requested records.
16. Finally, sign and date the form. If someone other than yourself is signing, indicate their relationship to you.
17. After filling out all fields, review your information for accuracy and completeness, then save your changes, download a copy, print it, or share it as needed.

Complete your request for medical records online today.