> Phone… Fax: (831) 625-4554. This review may take an additional 7-10 days to process. Visit our Patient Portal Page Here Please note that if attempting to review your child(s) medical records without portal access yet, please call medical records first to receive additional instructions at (330) 263-8615. COVID-19 information and resources, Home > Patients & Visitors > For patients > Medical records. If you have questions about the process for requesting medical records, please contact the HIM Release of Information department directly at 317-355-5802. Chart corrections may be requested in MyChart or by completing this Request for Amendment form and emailing patientamendments@eCommunity.com. Fax: (360) 374-6238. Indianapolis, IN 46219 Contact Us. Some medical records such as laboratory and medical imaging are available online through MyChart and Central Coast Health Connect. P.O. For other care needs, call 317-621-2727 to be directed. If you have problems accessing the form, call 315 464-7832 (downtown) or 315 492-5565 (community) In Person: If you would like to request a copy of your medical record in person, the Release of Patient Information Services is located in room 1500 on the first floor of University Hospital. For other care needs, call 317-621-2727 to be directed. Fax: 317-351-7728. Please Note: For patients requesting copies of their behavioral health records, all treating providers must review and approve the request prior to the release of any information. Obtaining a copy of your MCH medical records is easy: 1. Please allow 7-14 business days for completion of a medical records request. Please include patient's identifiers, contact information and description of information you are seeking. : Medical Records/HIM 388 Ben Bolt Ave. Tazewell, VA 24651. For Community Regional Medical Center: Community Regional Medical Center Attn: Health Information Management Department P.O. Forks Community Hospital 530 Bogachiel Way Forks, WA 98331. Phone: (831) 625-4577. 1500 North Ritter Avenue. For other questions about medical records, call the phone number below at the location where you received service. Community Hospital in McCook, Nebraska provides advanced care to more than 30,000 people throughout southwest Nebraska and northwest Kansas. Franklin Woods Community Hospital. Main Hospital (951) 788-3000; Consult-A-Nurse® (951) 788-3463; Medical Records (Health Information Management) (951) 788-3165; View Full Directory Mail to: Fairbanks, Attn: Medical Records, 8102 Clearvista Pkwy, Indianapolis, IN 46256 Fax: (785) 210-3435. From Illinois 800-914-8914. If you would like to request copies of your records, you may do any of the following: Community Health Network patients may request free copies of their medical records via mail, fax or MyChart. If you need more information, please contact us. Choose if you have an activation code or need an activation code and follow the steps to create an account. Hours: Monday - Friday, 8 a.m. to 4:30 p.m. Once logged into MyChart, click the "Your Menu" icon at the top left. Community Virtual Care visits available 24/7. As a service to our patients, copies of medical records for continuing medical care are provided free of charge if … If you do not yet have a MyChart account, you can easily create one. Download: Authorization to Release and Disclose Patient Information (PDF), Community Health NetworkAttn: HIM Release of Information Fax your authorization or facility's coversheet/letterhead to 317-351-7728. We are still available to assist with your medical record needs in other ways. Main Hospital Number (423) 302-1000 Administration. To register for MyChart, our patient communication and information system, please choose from the following options: If you have an activation code from your enrollment letter/provider: Need Care? limited or unavailable. *Note that some medical records may only be available through our hospital Medical Records office. Contact the Norwalk Hospital Medical Record Department. Knox Community Hospital ATTN: Medical Records 1330 Coshocton Road Mount Vernon Ohio 43050 We will send your records immediately upon request. Mail or fax the form to our centralized HIM location: To receive a copy of your behavioral health record, download and complete this form: To release your behavioral health record to anyone other than yourself, download and complete this form. To obtain your medical records, you may: 1. By email: himroi@chomp.org. For fast information, find the department you need to contact and dial them directly: Main Phone Number: (559) 675-5555; Department direct dial phone numbers are listed below. If you have any questions, you may contact Medical Records Services at … Fax to: 631-447-3077 Attn: HIM Dept. Medical Records Obtaining copies of your medical record. Non-Medical. Our office is open Monday thru Friday 8:00 am to 4:00 pm, closed weekends and holidays. Access Patient Portal. $8-10. You can print our Authorization to Disclose Records, fill out in its entirety, then fax to the number on the form or mail your request in to: 800 W. Central Rd Arlington Heights, IL 60005 Attn: Medical Records; You can pre-order your Radiology CD by using this form. Fax hours are Monday - Friday, 8 a.m. to 4:30 p.m. For release requests after hours/weekends/holidays, please call HIM at 317-355-5752. Emergency Room 219-836-4511. See instructions below for patients, healthcare providers and third parties. Need help? There are multiple ways to request a copy of your medical record, including online through MyChart or by mail. Print medical records request form - en Espanol. Contact our Health Information Services Department for more information or to schedule an appointment to view your health or medical record. Download the Medical Records Request form by clicking here 2. Preferred contact number (home phone/mobile phone) of the person making the request Provider information from whom records are being requested; include the provider’s name and/or the name of the hospital, surgery center or health center/clinic that provided the service Asante Rogue Regional Medical Center. Records will be delivered electronically back to your MyChart account. Hours: Monday - Friday, 8 a.m. to 4 p.m. Below you will find the MCH Phone Directory. Phone: 317-585-5423 See our COVID-19 FAQ for visitor guidelines and more. Helpful Information. Request to amend Protected Health Information. To request patient records from Community Rehab Hospital North or South, download and fill out this form: Patient Request for Release of Information (PDF) Mail or fax the request form to the appropriate location: Community Rehabilitation Hospital North Attn: HIM Department 7343 Clearvista Drive Indianapolis, IN 46256 Fax: 317-585-5472. There is a reasonable cost-based fee for obtaining record copies. Please note that it can take up to 30 days as allowed by law. Patient Billing 219-934-8888. : HIM/Medical Records 159 Hartley Way Pearisburg, VA 24134. 541-789-7000. For walk-in clients only the AD-66 form is available in the Medical Records department, or print and complete prior to your visit. Get a ride. Phone: 317-849-8222 or (toll-free) 800-225-4673, Option 6 Phone Numbers and Extensions; Phone Numbers and Extensions. 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