Renton, Seattle & Tacoma

Medical Records Request

To Obtain A Copy Of Your Medical Records

Please complete and sign these request forms, following the instructions below:

1. Records can be faxed, mailed, or picked up at the clinic. In the “To:” section of the Medical Release form, tell us to whom and how/where the records are to be released. Examples of this section:

      • To: Dr. Smith at Fax #: 555-555-5555
      • To: Dr. Washington at 1111 W 5th St. Somewhere WA 55555
      • To: Myself-Pick up at Renton Clinic

2. Give a current phone number in case there is a question about the request.

3. Copy of ID needs to be included with the record release forms.

4. The release & ID can be dropped off at the clinic, faxed to 509-575-0477, mailed to 106 East E Street Yakima, WA 98901 or sent through the form form below:
 

Your Name (required)

Your Phone (required)

Your Email (required)

Mailing Address in USA, Canada or Mexico:

City, State, Postal Code:

Your Message

Attach signed request form & copy of ID here:

Type this validation code into the box below.

captcha

Testimonials
Today at Cedar River, my visit was excellent. The staff treated me very good, it felt like family. They don’t judge you and they are very trusting.

Facebook Status

Cedar River Clinics
August 28, 2014 at 6:39 pm

Thank you to PBS for broadcasting After Tiller this Monday (and online in September)! It's a great documentary about four doctors who perform later abortions and includes moving patient stories.
Seattle Area Broadcast: Monday, September 1, 2014 at 10:00 PM Online: Sept. 2, 2014 – Oct. 1, 2014

Facebook Picture
After Tiller | POV | PBS

www.pbs.org

Since the assassination of Dr. George Tiller in 2009, only four doctors in the country openly provide late abortions. With unprecedented access, After Tiller goes inside the lives of these physicians working at the center of the storm.

Cedar River Clinics
August 28, 2014 at 12:06 am

"And all I needed then was to not feel alone, to appreciate the women who had faced this before me, to know that they had survived."

Facebook Picture
New Statesman | “You’ll ruin my life”: one woman’s experience of abortion and the Catholic church

www.newstatesman.com

“Asking the nurse not to turn the ultrasound away, I saw our baby, the same size as a chickpea, and wondered how an innocent thing could ever be shameful.”