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
Thank you for being a bright spot and safe place during our difficult decision.

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Cedar River Clinics
November 27, 2014 at 9:09 am

Happy Thanksgiving!
On this day, we give gratitude for all that is important to us.
We are thankful for you, our supporters!
We are thankful for our clients who trust us with their health and well-being!
We are thankful for our courageous and caring staff!
We are thankful for all those that work for reproductive rights and defend our freedom of choice!
Happy Holidays to you and yours!

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Cedar River Clinics
November 25, 2014 at 7:16 pm

Cedar River Clinics shared Repeal Hyde Art Project's photo.

We want a world where everyone can parent their children without fear. This is the world we all deserve – but not the world we live in yet.

Our hearts are with #Ferguson. #BlackLivesMatter

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By: Repeal Hyde Art Project

Cedar River Clinics
November 24, 2014 at 8:07 pm

"A feminist knitting circle in Norman brought the girls' stories to our attention; they also set up a Facebook page supporting them, Yes All Daughters, and helped organize today's walkout." #YesAllDaughters

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Oklahoma Students Stage Walkout to Protest Bullying of Rape Victims

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These strong and intelligent young women give me hope for the future of the human race. #YesAllDaughters pic.twitter.com/3KfGXtQUut — Rachel Irick (@RachIrick) November 24, 2014