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.

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Testimonials
I thank you for taking your time, holding my hand as you listen to my words, as you dried my tears.

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Cedar River Clinics
September 29, 2014 at 7:37 pm

"The legislation says silence or lack of resistance does not constitute consent. Under the bill, someone who is drunk, drugged, unconscious or asleep cannot grant consent."

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California Adopts 'Yes Means Yes' Sex-Assault Rule

abcnews.go.com

Gov. Jerry Brown announced Sunday that he has signed a bill that makes California the first in the nation to define when "yes means yes" and adopt requirements for colleges to follow when investigating sexual assault reports. State lawmakers last month approved SB967 by Sen. Kevin de Leon,...

Cedar River Clinics
September 29, 2014 at 7:28 pm

The best wedding coverage yet! Amal is the superstar in this couple.

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Internationally acclaimed barrister Amal Alamuddin marries an actor - The Business Woman Media

www.thebusinesswomanmedia.com

Amal Alamuddin, a 36 year old London-based dual-qualified English barrister and New York litigation attorney marries actor names George Clooney.

Cedar River Clinics
September 25, 2014 at 12:19 am

Thank you, Sen. Murray!
"The Emergency Contraception Access and Education Act of 2014 would require any hospital that receives federal funding under Medicare or Medicaid, which includes Catholic hospitals, to both inform sexual assault survivors who come to the emergency room about emergency contraception and to offer it to them regardless of their ability to pay."

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Sen. Murray Introduces Legislation to Improve Emergency Contraception Education, Access

rhrealitycheck.org

Sen. Patty Murray has introduced a bill that would both educate the public about emergency contraception and make it available to more rape survivors who go to the emergency room.