Instructions for Release to Third-Party

This website allows you to submit requests for copies of a patient's medical records to be sent to yourself or to someone else. Please read the important notes below before continuing to use this system:

  1. This website is designed for patients or parties with the power to make decisions on behalf of a patient (e.g. parents, guardians, personal representatives) to request records. Third parties should click here to view other options for requesting medical records.
  2. In order to protect the patient's privacy and comply with federal and state regulations, we need a copy of your driver's license or other government-issued ID as well as proof you are authorized to make medical decisions for the patient (if you are not the patient) before we can release records. Failure to upload all required documents through this system within 72 hours after beginning the process will result in your request being canceled.
    • If you are on a mobile device (e.g. smartphone/tablet), you will need to electronically sign an authorization form and submit a picture of yourself holding your government-issued ID.
    • If you are on a non-mobile device (e.g. desktop/laptop computer) you will need to print, manually sign, and upload a scanned copy of an authorization form as well as your government-issued ID.
  3. If you are not the patient, you will also need to submit a legible image (picture or scanned) of proof you are authorized to make medical decisions for the patient.
  4. Information requested through this system must exactly match hospital records. Typographic errors, such as patient name misspelling or incorrect dates of service, may result in your request being canceled or delayed.
  5. There may be a clerical/reproduction processing fee charged. Items not able to be delivered electronically (e.g. Radiology Imaging CDs) may incur additional charges, which will be displayed if selected.
  6. If you request records from multiple facilities, you will get ONE tracking number for each facility, as each facility processes records separately. You will receive separate notifications and records from each facility.

If you are unable to complete the above, please refer to this page to review other options for submitting your request.