We are happy to help you obtain copies of your health records from the location where you received care. Please select one of the care sites below and follow the link to a page where you can download and complete the appropriate authorization form.
You can send your request to us through fax, mail, email, or in person. If you email the authorization form, it must be attached as a scanned document.
Make sure your form:
- Is properly addressed to the facility being asked to release the information
- Has the address of the facility or person receiving the information
Be sure your form has the patient’s:
- Full name, including previously used names
- Date of birth
- Social Security number
Additional necessary information:
- The information and date(s) of service you want released
- How much information: Pertinent records may include a discharge summary, history and physical, test results, an emergency department report, and any consultations; all records include all vitals and large amounts of routine documentation
- The reason you want the information released
- Instructions on whether you want to pickup the information or have it mailed
- The date of your request
- The patient’s signature
If the patient is unable to sign the request form due to a physical or mental disability, a guardian or court-named personal representative may sign for the patient. If the patient has no guardian or personal representative, the individual with medical power of attorney may sign for the patient. You must provide appropriate legal documentation with the request form if the patient is unable to provide his or her own signature.
We regret that we cannot accept digital signatures.
While our care sites can provide medical information and records, we cannot provide copies of birth certificates. For a copy of a birth certificate, please contact your local state government.
Our care sites will fulfill your medical records request within 7-10 business days, and will inform you if they experience an unexpected delay.
We may apply fees or charges in accordance with SCL Health policies, but we will notify you of any applicable fees before we process your request.
If you have any questions or need further assistance, please contact the facility you are asking to provide medical records.