Medical Records Release
The Center for Minimally Invasive Surgery is happy to provide the release of medical records for our patients to authorized persons and/or guardians. The patient or responsible party will need to complete and sign the PHI Release/Disclosure Authorization form when requesting the release of medical records. The Center for Minimally Invasive Surgery provides the following guidelines for all requests:
Photo ID of person requesting medical records release.
Name and address of the third party to which records are being released. (if applicable)
Appropriate fees as determined by the Facility Administrator or Business Office Manager. (if applicable)
A copy of the PHI Release/Disclosure Authorization Form should be filed in the patient’s chart.
Download the PHI Release/Disclosure Authorization form now: PHI Release/Disclosure Authorization
