Health Information Management/Medical Records
To request a copy of your medical records, please select the appropriate form below. Print, complete, sign, date and fax the form to numbers listed. Call if you need more assistance.
- Fax and phone numbers listed here.
- If you are mailing a request, write "Attention Health Information Management - ROI" on the envelope and mail to:
Attention: Health Information Management- ROI
1115 SE 164th Avenue, Dept. 336
Vancouver, WA 98683
Upon receipt of the completed form, we will either promptly process your request or contact you if further information is needed. If a fee is assessed for processing the requested records, you will be called in advance.
Request Restriction of your Protected Health Information
To Request Restriction of your Protected Health Information, please choose the appropriate form.
Request for Amendment of Protected Health Information
Request for Alternate Communications of Protected Health Information
PHMG Family and Friends Information Form
If you have questions about obtaining copies of medical records, phone and fax numbers for the Release of Information staff are listed here.