Medical Records

Request a copy of your records online or download and complete one of the medical request forms below. Follow the instructions within the PDF to return the document via email, fax or mail. There is a small processing fee for medical record requests.

• Medical Records Request - English
• Medical Records Request - Visually Impaired
• Solicitud de registros médicos - Spanish
• Запрос медицинской документации - Russian
• 医疗记录请求 - Mandarin
• Kahilingang Medikal - Tagalog
• ਡਾਕਟਰੀ ਰਿਕਾਰਡ ਬੇਨਤੀ - Punjabi
• طلب السجلات الطبية - Arabic
• Ifa usun ai upwe angei taropwen ai safei? - Chuukese
• Yêu cầu hồ sơ y tế - Vietnamese

Non-PeaceHealth providers may request records free of charge by calling 1-844-962-2090.

Download, complete and submit one of the request for restrictions forms below prior to receiving services or treatments:

• Request for Restrictions of PHI - English
• Request for Restrictions of PHI - Visually Impaired
• Solicitud de restricciones para la información médica protegida - Spanish
• Запрос на ограничение использования и раскрытия охраняемой медицинской информации - Russian
• 受保护健康信息限制请求 - Mandarin
• Kahilingan para sa Mga Paghihigpit ng Protektadong Impormasyon sa Kalusugan - Tagalog
• ਸੁਰੱ ਖਿਅਤ ਖਸਹਤ ਜਾਣਕਾਰੀ ਤੇਪਾਬੰ ਦੀ ਲਈ ਬੇਨਤ - Punjabi
• طلب تقیید المعلومات الصحیة المحمیة - Arabic
• Tingor ren amonomonen porousen aninisin pioing - Chuukese

Download, complete and submit one of the request for amendment forms below by mailing to:

PeaceHealth
Attention: Health Information Management- ROI
1115 SE 164th Avenue, Dept. 336
Vancouver, WA 98683

• Request for Amendment – English
• SOLICITUD DE ENMIENDA DE LA INFORMACIÓN MÉDICA PROTEGIDA – Spanish
• ЗАПРОС НА ВНЕСЕНИЕ ПОПРАВКИ В ЗАЩИЩЕННУЮ МЕДИЦИНСКУЮ – Russian
• KAHILINGAN PARA SA PAGBABAGO NG PROTEKTADONG IMPORMASYON – Tagalog
• TINGOREN EKKESIIWININ AAN EPWE ISOIS EECH POROUSOMW - Chuukese
• 受保护健康信息修正请求 - Mandarin 
• صحية محمية طلب تعديل معلومات - Arabic
• YÊU CẦU SỬA ĐỔI THÔNG TIN SỨC KHỎE ĐƯỢC BẢO VỆ - Vietnamese
• ਸੁਰੱਿਖਅਤ ਿਸਹਤ ਜਾਣਕਾਰੀ ਿਵੱਚ ਸੋਧ ਲਈ ਬੇਨਤੀ - Punjabi
• REQUEST FOR AMENDMENT OF PROTECTED HEALTH INFORMATION - Visually Impaired

PeaceHealth supports Health Records for iPhone users with Apple’s Health app. The app allows patients to view and track health information, including lab results, immunizations and medications from PeaceHealth and other participating health organizations. To use the Health Records feature, patients must have a MyPeaceHealth account.