Adventhealth Medical Records Request Form

Webfor adventist health locations, there are three ways to request your medical records.

Webwe'll email you a confirmation of your request when you're finished.

Please email me a copy of my completed request form.

This will include personally identifiable, protected.

Webauthorization to release medical information * indicates a required field.

Completion of this document authorizes the disclosure and use of health information.

Webadventhealth is a personalized healthcare app.

Create an account for easy access to doctors, extended medical services and your health records.

Webto request release of medical information please complete and sign this form.

I, ____________________________________hereby voluntarily authorize.

Webplease contact the health information management (him) department for your facility by calling the number listed under records request forms and contact information or by.

Webyou'll have direct access to your medical records including lab results, medical images, surgeries, physician notes and more.

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