Request Medical Records

If you have a MyChart account, log in to see if the information you’re seeking is there. You can download, print and send information to health care providers from your MyChart account. If you don’t have a MyChart account yet, ask about setting one up the next time you visit your doctor’s office.

If you’re not on MyChart, or the information you need is not available on MyChart, download and complete the Release of Information Form [PDF]. (The form also is available in Spanish.)

Release of Information Form Instructions

Contact the office of the doctor you want to request records from. You’ll need to:

  • Get the practice name, address, phone number and fax number needed for the first box on the form. You’ll use the practice name again in blank after the phrase “I authorize Cone Health or”.
  • Ask how you can submit the completed form (for example: fax, mail, email or in-person).
  • Find out if there is a fee for your medical record copy.

Print or electronically fill in the form. Complete all applicable fields. You must include the purpose of your request.

Be sure to select which information you need disclosed. Most health care facilities do not require or want your entire record.

Sign and date the form, and then submit it to your doctor’s office. (Electronic signatures aren’t accepted.)

Please note: If you want your copies sent to another health care facility, first ask what it requires and whether it’s on the EPIC health information management system. If it’s on EPIC, you may not need to complete the request form.

To view our full privacy policy, click here.

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