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 425-255-0262, mailed to 263 Rainier Avenue S, Suite 200, Renton, WA 98057 or sent through the form form below: