Medical Records Request

Instructions

To Obtain A Copy Of Your Medical Records

Please complete and sign these release forms, following the instructions below:

1. Records can be faxed, mailed, or picked up at the clinic. In the “To:” section of the Medical Release form, tell us to whom and how/where the records are to be released. Examples of this section:

2. Give a current phone number in case there is a question about the request.

3. A copy of ID needs to be included with the record release forms.

4. The release & ID can be dropped off at the clinic, faxed to 425-255-0262, mailed to 263 Rainier Avenue S, Suite 200, Renton, WA 98057 or sent through the Medical Records Request Form. 

Medical Records Request Form

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