Health Information Management/Medical Records

Health Information Management/Medical Records

To request a copy of your medical records, please select the appropriate form below. Print, complete, sign, date and fax the form to numbers listed. Call if you need more assistance.  

  • ​Fax  and phone numbers listed here​.
  • If you are mailing a request, write "Attention Health Information Management - ROI" on the envelope and mail to: 
         Attention: Health Information Management- ROI
         1115 SE 164th Avenue, Dept. 336
         Vancouver, WA 98683 

Upon receipt of the completed form, we will either promptly process your request or contact you if further information is needed. If a fee is assessed for processing the requested records, you will be called in advance.

​Request my medical records

Additional Forms

Request Restriction of your Protected Health Information

To Request Restriction of your Protected Health Information, please choose the appropriate form.

Request for Amendment of Protected Health Information

Patient Communication Preferences Forms

Additional questions?

If you have questions about obtaining copies of medical records, phone and fax numbers for the Release of Information staff are listed here: Health Information Management Release of Information Contact Information  ​​​