Intermountain Healthcare understands the importance and sensitivity of your health information. We also understand the importance of giving you easy access to your medical records and keeping those records private.

How to Request Your Medical Records

Note: There may be a fee for providing copies of your medical records.

  1. To request a copy of your medical records, download the Authorization for Release of Health Information Form using the link below.
  2. Please fill out the form completely. Be sure to sign and add the date to avoid delays in processing your request. We have up to 30 days to respond to a request for records.
  3. Please return the completed and signed form using one of these options:
    • Mail or fax your form to the Medical Records Department located in the facility where you received care. Refer to the link above for addresses and fax numbers.
    • Email your form to the Corporate Medical Records Department by referring to the email address located to the right.
    • If you are a third-party requesting medical records for a patient, please use the following link: Third Party Medical Records Request Form NOTE: Attorneys may use this form to submit subpoenas and court orders. Disregard notice on submission form.
  4. In order to obtain records from Intermountain Healthcare facilities or providers, the specific facility and/or provider needs to be addressed in the authorization. This includes providing the name, physical address, and phone number of a facility and/or provider on your authorization form by referring to the links to the right.

If you have any questions or issues regarding the medical records release of information process, please contact the Medical Records Request Line using the phone numbers listed to the right. 


Authorization for Release of Health Information Form

Fill out this form to authorize the release of your health information. 


Patient Privacy Notice

Learn about how we safeguard your privacy.


Patient Responsiblities

Find information about your responsibilities as a patient. 


Medical Records Department Directory

Find the physical address or fax number of the Medical Records Department that you need to contact to request your medical records.