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 Medical Records

1. A valid and complete Authorization for Release of Health Information Form signed and dated by the patient is required to request medical records. If needed, download and complete the Authorization for Release of Health Information Form. 

For specific records, provide the name, address, and phone number of the facility or provider on the authorization form by referring to the links on the right. Otherwise, you may use ‘Intermountain Healthcare’.

2. Return the completed form with one of the following options:

Preferred Option

  • Fill out the Request Submission Form below and attach a completed PDF version of the Authorization for Release of Health Information Form.
    Note: Law firms may use this form to submit subpoenas and court orders. Disregard notice on submission form.

Other Options

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 number listed to the right. 

 Note

  • There will be a fee for providing copies of your medical records.
  • Medical records requests will be filled within 30 days of your request.

 

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Authorization for Release of Health Information Form

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

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Patient Privacy Notice

Learn about how we safeguard your privacy.

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Patient Responsiblities

Find information about your responsibilities as a patient. 

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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.