Looking to Obtain a Copy of Your Medical Records?

Paper Copy of Medical Records:

Federal HIPAA laws require an authorization to be completed for all medical record requests, unless your provider is requesting them for your care. Your medical record, and the information it contains, is confidential. Therefore, we must confirm your identity before releasing your medical record. Only the patient or his/her legal guardian can sign the form. You can download the authorization form below:

Release of Information Form:


Download Forms


Medical Records Release

English

Spanish


Walk-In Hours

To obtain your medical record, bring the completed and signed authorization for and a government issued photo ID (passport, driver's license, etc.) to the Ciox Office located in the Medical Office Building just west of Lakeview Hospital at 520 East Medical Drive, Suite 230. We are available to accept medical records requests between the hours of 8:30am and 4:30pm.

  1. Authorization for Use and Disclosure of PHI Form Completed and signed
  2. A current government issued photo ID (passport, driver’s license, State ID, or military ID)

Please be aware that it may take 5–7 business days to receive your records.

Behavioral Health records require additional processing and must be approved by your physician. This process may take up to 45 days.


Records for your Physician

Our goal is to get your health information to the appropriate health care provider as quickly as possible; therefore we recommend that your physician (or other healthcare provider) request a copy of your medical records to be delivered directly to his/her office by fax. There is no charge to you for this service.

Contact Information

If you have additional questions, you may call our Release of Information specialists at (801) 299-2552. Our fax number is (801) 299-4630.

Read more about our responsibilities and your rights for privacy.