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Medical Record Requests

THIS HAS BEEN WRITTEN USING BO-23 AS A GUIDE. BUSINESS OFFICE SHOULD REVIEW THIS FOR ACCURACY AND SUGGEST REVISIONS. 

Providers, Insurance Companies, DES, and Patients/Guardians may receive medical records if a completed Release of Information form has been signed by the patient. Records will be mailed or faxed to facility.

Outside agencies other than those previously mentioned will be referred to our Quality Improvement Manager, or designee, for validation prior to fulfilling the request. Once validated, records will be mailed or faxed. A fee of $15.00 plus $0.30/page will be due upon receipt of medical records.

If a request is made to outside hospitals and specialists, a continuity of care form will be required to me mailed or faxed to our facility.

Desert Senita is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Federal Tort Claims Act (FTCA) Public Health Service employee under 42 U.S.C. 233(g)-(n).