Medical Records

Request a copy of your records online or download and complete a medical record request form from below. Follow the instructions within the document to return the form. There is a state regulated processing fee for medical record requests.

• Medical Records Request - English
• Medical Records Request - Visually Impaired
• Solicitud de registros médicos - Spanish
• Запрос медицинской документации - Russian
• 医疗记录请求 - Mandarin
• Kahilingang Medikal - Tagalog
• ਡਾਕਟਰੀ ਰਿਕਾਰਡ ਬੇਨਤੀ - Punjabi
• طلب السجلات الطبية - Arabic
• Ifa usun ai upwe angei taropwen ai safei? - Chuukese
• Yêu cầu hồ sơ y tế - Vietnamese

Request a copy of your records be sent to a third party, such as a law office or a school, or allow us to discuss your health information with others.

• Authorization to Use and Disclose Health Information -English
• Разрешение на использование и раскрытие медицинской информации - Russian
• Autorización para usar y divulgar información de salud - Spanish
• Awtorisasyon upang Gamitin at Ihayag ang Impormasyon sa Kalusugan - Tagalog
• Authorization to Use and Disclose Health Information - VIE
• Giấy cho phép Sử dụng và Tiết lộ Thông tin Sức khỏe - Vietnamese

Non-PeaceHealth providers may request records free of charge by sending a request, in writing and on letterhead, by email or fax.

Download and complete a request for amendment form from below and submit by following the instructions within the form.

• Request for Amendment – English
• SOLICITUD DE ENMIENDA DE LA INFORMACIÓN MÉDICA PROTEGIDA – Spanish
• ЗАПРОС НА ВНЕСЕНИЕ ПОПРАВКИ В ЗАЩИЩЕННУЮ МЕДИЦИНСКУЮ – Russian
• KAHILINGAN PARA SA PAGBABAGO NG PROTEKTADONG IMPORMASYON – Tagalog
• TINGOREN EKKESIIWININ AAN EPWE ISOIS EECH POROUSOMW - Chuukese
• 受保护健康信息修正请求 - Mandarin 
• صحية محمية طلب تعديل معلومات - Arabic
• YÊU CẦU SỬA ĐỔI THÔNG TIN SỨC KHỎE ĐƯỢC BẢO VỆ - Vietnamese
• ਸੁਰੱਿਖਅਤ ਿਸਹਤ ਜਾਣਕਾਰੀ ਿਵੱਚ ਸੋਧ ਲਈ ਬੇਨਤੀ - Punjabi
• REQUEST FOR AMENDMENT OF PROTECTED HEALTH INFORMATION - Visually Impaired

PeaceHealth supports Health Records for iPhone users with Apple’s Health app. The app allows patients to view and track health information, including lab results, immunizations and medications from PeaceHealth and other participating health organizations. To use the Health Records feature, patients must have a MyPeaceHealth account.