Call us: (425) 899-1000

Your Medical Records

Request Your Medical Records

To request a copy of your medical records, download and complete the authorization form.

Make a photocopy of a government-issued photo ID card, such as a driver’s license.

Send the completed authorization form, along with the photocopy of the ID card, to the Medical Records department by one of the following methods:

  • Fax to 425.899.1933 (for EvergreenHealth medical records)
  • Fax to 425.899.1918 (for EvergreenHealth Primary Care medical records)
  • Mail to EvergreenHealth, Health Information Management MS-49, 12040 NE 128th Street, Kirkland, WA 98034
  • Deliver in person to the Health Information Management (Medical Records) office, Room Red-B-514 at EvergreenHealth Medical Center (click for directions) during business hours Mon-Fri, 8am-5pm.

If the medical records are being sent directly to a different health care facility, we will accomodate your needs and send the records out, free of charge.

If the medical records are for personal use, you can pick them up at Room Red-B-514 at EvergreenHealth Medical Center (click for directions) during business hours Mon-Fri, 8am-5pm.

  • The records will only be released to the individual whose name is on the authorization form
  • You must show a government-issued photo ID card

If you have questions about your medical record request, please contact us at 425.899.1920 during business hours Mon-Fri, 8am to 5pm.


Cost of Medical Record Copies

There is no charge for medical records to be sent directly to a health care provider.

If you are requesting your medical record for personal use, the following fees apply:

  • First 10 pages are free
  • Next 20 pages are $.96 per page, plus 10% tax
  • Beyond 30 pages are $.73 per page, plus 10% tax

Amendment Request to Your Medical Records

If you wish to submit an amendment request to your medical record, please download and complete this form.

Send the completed form to the Health Information Management (Medical Records) department by one of the following methods:

  • Fax to 425.899.1933 (for EvergreenHealth medical records)
  • Fax to 425.899.1918 (for EvergreenHealth Primary Care medical records)
  • Mail to EvergreenHealth, Health Information Management MS-49, 12040 NE 128th Street, Kirkland, WA 98034

If you have questions about the process for requesting changes to your medical record, please contact us at 425.899.1920 during business hours Mon-Fri, 8am to 5pm.
 

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