Electronic Health Information Request Form - Thank You

Your Request has been submitted.


Thank you. Responses to requests for information will be provided within ten (10) business days. For follow-up assistance, please contact us.

To submit another request, please click here.


Note: If you are a patient looking for medical records for yourself or for someone that you’re a proxy for, please visit our medical records page. If you are a physician needing access to a patient’s record, please contact HIM/Medical Records.