In need of your medical records?

Medical Records

We want to guard your privacy and ensure that your medical records are only seen by you, your healthcare providers and those you may grant consent to.

In order to release your medical records for your use or to a third party you have consented to release your record to, please complete a Medical Release Form.  

You can also stop by our front office and request it. Please make sure you fill out the form completely to ensure accuracy with the medical records being requested and released. Only information specified on the form will be provided.

Patients can receive one year of medical records with no charge.  For more than a year, a fee of $15.00 plus $0.30 per page will be due upon request of medical records.  

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

Ajo Office

(520) 387-5651
Feel free to give us a call if you have any questions.

Proud Partners

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

Desert Senita Community Health Center sites are Federal Tort Claims Act (FTCA) deemed facilities.

Translate this Page

© Copyright by Desert Senita 2018 | Site Design by Caitlyn Allen, LLC

Scroll Up