Yuma Regional Medical Center
 

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Health Records Release of Information

Effective January 17, 2014; you may obtain full copies of your health records at Yuma Regional Corporate Center, 399 W. 32nd St. You still have the option to collect your records from the existing main office for Release of Information until February 17, 2014, but please note that this will be a temporary desk as the main office will also close on February 17, 2014, and will be located at the Yuma Regional Corporate Center at that time.

If you would like to receive a copy of your Health Records, please fill out the Authorization to Release Protected Health Information. The authorization form must be notarized.

Please make sure your name, date of birth, address, telephone number and date of record request are on the consent form to assure locating your records.

Please specify if the records are to be mailed to you or another person of your choice. If it is your physician, please provide the mailing address or fax number.

Please sign the consent form for identification purposes.

You may fax or e-mail this consent form back to Yuma Regional Medical Center.

Fax: 928-336-7154
Attn: Release of Information
Email: releaseofinformation@yumaregional.org

If you are in need of personal assistance, please call 928-336-7017.


© 2014   Yuma Regional Medical Center  |  2400 S. Avenue A  |  Yuma, AZ 85364  |  928-344-2000