Health Information Management/Medical Records
To request a copy of your medical records please select the appropriate form below. Print, complete, sign and date the form, then mail or fax it to the contact information listed below. If you are mailing a request, write "Attention Health Information Management- ROI" on the envelope.
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.
If you have questions about obtaining copies of medical records, the address, phone and fax numbers for the Release of Information staff are listed below.
Contact Information
Cottage Grove Community Medical Center and PeaceHealth Medical Group
1515 Village Drive
Cottage Grove, OR 97424-9700
Phone: (541) 767-5433
Fax: (541) 942-0353
