Medical Records / Release of Information
To get copies of your Medical Records please follow the helpful tips below and fill out the appropriate form(s) based on what records you need:
Click the following links to download the appropriate blank form(s):
- Request for Access to Protected Health Information - to request copies of a chart for yourself.
- Release of Information or Authorization - to request that your records be sent to a third party.
- Publicación de información o autorización para compartirla
For faster processing, fax the form to 303-996-1047.
Otherwise, you may send in the mail to: Medical Records, 155 Inverness Drive West, Englewood, CO 80112
Call Medical Records at 303-723-4270 with any questions or concerns.
- Be sure to sign and date.
- If the records requested belong to a person 18 years of age or older, the client or the client's legal guardian must sign the form.
- If the records requested belong to a person under the age of 18, a parent or guardian must sign the form.
- If the records have information about Substance Abuse treatment, the release must be signed by the individual if they are 13 years of age or older.
- If the individual is under the age of 13, a parent or guardian must sign the form.
- Specify the name, address, and telephone number of the person or place the records should be sent.
- Specify what part of the medical record should be released; diagnosis only, medication list, doctor’s notes, etc.
- Please allow up to 30 days for your request to be processed
- Please note any release to self is subject to review by one of our doctors before we may send them.
- If you're a new client, we recommend a discussion with your personal clinician to determine which records he or she may need to ensure the best possible care. It may not be necessary for all of your records to be transferred from your physician or previous mental health care provider.