We are dedicated to keeping your medical information private and confidential, which is why we require a completed and signed authorization form in order to release your records.
To Request Copies of Your Medical Records
- Download and print our Authorization for Release of Information Form, or call our Health Information Department at 651-312-1553 to request this form.
- Return your completed & signed release form
- By Mail to:
- By Fax to: 651-312-1570
- Your information will be sent by mail unless otherwise specified
FAQ's About Obtaining Copies of Medical Records
Q: I want a copy of my medical records for my own personal file. How do I go about getting these records?
A: Log into your Pelvic Floor Center® patient portal account and message us a request for your records or simply call our Health Information Department at 651-312-1553 and speak with one of our Health Information Technicians. You will be asked to complete an Authorization for Release of Information Form. You can download and print this form, or we can mail or fax this form to you. The completed authorization form can be returned to us by fax, 651-312-1570, by mail, or in person. Your request will be processed when the completed form is returned to us.
Q: Is there a charge to obtain my records for my personal use?
A: No. This is a service we provide to our patients free of charge. In some situations, we do charge a fee in accordance with state law for certain types of record releases such as Attending Physician Statements, applications for insurance coverage, social security applications, legal requests and in certain other situations. We will inform you if there is a charge prior to releasing the records.
Q: How long will it take to receive my medical records?
A: Every attempt will be made to process requests for medical records within 48 hours. Please be aware, however, that your request may take longer if your physician has not yet completed documenting your most current visit. Our goal is to give you a complete and current copy of your records. To achieve that goal, your request may take longer than 48 hours.
Q: I have an appointment to see another doctor or a specialist for a second opinion. I would like this doctor to have a copy of my records. How do I make sure my doctor gets these records?
A: Simply call our Health Information Department at 651-312-1553. You will be asked to complete an Authorization for Release of Information Form, and to supply us with the name and address of the clinic where your records are to be sent. Once the authorization form is received, your request will be processed. There is no charge for this service.
Q: My appointment with the other doctor or specialist is tomorrow morning. Can I rush this request?
A: Yes. Simply call our Health Information Department at 651-312-1553 to begin the process. Please be sure to tell us that this is a rush request. If you are in one of our clinics and need a copy of your medical records quickly, a clinic staff member who is trained in the release of medical records will assist you. You will be asked to fill out the Authorization for Release of Information form in the clinic, and the clinic staff will make every attempt to process your request within the requested time frame. There is no charge for rush requests.
We encourage you to contact our Health Information Department at 651-312-1553 if you have any further questions. A Health Information Technician will be available to assist you between the hours of 8:30 a.m. and 5:00 p.m. Monday through Friday.