Instructions for Submitting Requests

---

Welcome! Please Read Below

• This ordering site is for use by patients only.
• All available Medical Records are provided online to patients for a flat fee of $20 per request.
• There are no refunds for any reason.
• All available Medical Records are provided. You will not be asked to specify the types of Medical Records or dates of service.
• Medical Records will be made available securely online only. We do not fax, email, or mail records.
• Allow 48 hours for your Medical Records request to be completed, excluding weekends and holidays.
• You will be texted or emailed when Medical Records are ready to access online (see text samples below).

Who Can Order Patient Records?

• Patients who have reached the age of majority: 18 years of age or older (NOTE: A parent may not request records on behalf of an adult child, regardless of insurance coverage, residence, etc.).
• Parents/guardians who have the legal authority to access a minor child's records.
• A person who has the legal authority (legally recognized personal representative, healthcare trustee/conservator, medical/healthcare power of attorney, legal guardian, executor/administrator of estate) to make healthcare decisions for a patient of any age.

What You Need to Get Started

1. The patient's valid driver's license or other valid government-issued ID.
2. If you are the parent/guardian of a minor or a personal representative of an adult patient, you will need your valid ID.
3. A credit card to make payment.
4. If you have legal authority to make healthcare decisions for a patient (such as legally authorized personal representative, guardian, healthcare trustee/conservator, medical/healthcare/durable power of attorney, or executor/administrator of estate), you must upload three items: (a) the patient's driver's license/ID or death certificate, (b) YOUR OWN Driver's License/ID, AND (c) official documentation of your authority to request patient records (such as Durable Power of Attorney for Healthcare/Medical Power of Attorney and Advanced Directive for patient and designated caregiver; Death Certificate for deceased patient). NOTE: Financial power of attorney is not sufficient. If you cannot provide both your and the patient's ID as well as proof of your legal right to access the patient's records, the patient must place his or her own request.

Please have these items handy before you start!

---