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At The Hospitals of Providence, it’s not only our job to keep you healthy. We’re also focused on keeping your healthcare information private as well.
If you’d like a copy of your medical records, please print out and complete the appropriate Authorization to Use and Disclose Health Information form included below.
The Hospitals of Providence Access Request Form (English)
The Hospitals of Providence Access Request Form (Spanish)
Bring this completed form as well as a photo ID when you come to pick up your records.
If someone else will be picking up your medical records, that person needs a photo ID and a signed authorization letter from you.
For more information, please call the Health Information Management Office at 915-577-7650.
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