Get Sutter Health My Health Online Release Of Information Request 2023-2025

Filling out the Sutter Health My Health Online Release Of Information Request is essential for accessing your personal health information securely and conveniently. This guide provides a clear, step-by-step process tailored to assist you in completing the form with confidence.

Follow the steps to successfully complete your request.

1. Click ‘Get Form’ button to obtain the form and open it in the appropriate online editor.
2. Fill in your Medical Record Number (MRN) and Date of Birth (DOB) in the designated fields. This information is crucial to verify your identity.
3. Indicate the type of document you are requesting by selecting the appropriate option from the 'Doc Type' dropdown menu.
4. Select your Sutter affiliate or hospital by choosing from the list provided. If your provider's name or hospital is not listed, you may write it in the specified area.
5. Read the statement regarding the confidentiality of your health information. Ensure you understand that certain test results cannot be released electronically.
6. Sign the form in the designated area to authorize the release of your health information. Include the date of your signature.
7. Complete the requester information section by providing your name, today's date, date of birth, email, mailing address, and phone number. Ensure all fields are filled out clearly and legibly.
8. After verifying all information for accuracy, save your changes. You may then download the completed form, print it, or share it as needed.
9. Submit the completed form by bringing it to your next medical appointment or by faxing or mailing it to the Patient Services Contact Center as specified.

To access your health information promptly, complete your Sutter Health My Health Online Release Of Information Request online today.