800-572-4223
Seattle, Renton, 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 425-255-0262, mailed to 263 Rainier Avenue S, Suite 200, Renton, WA 98057 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:

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Join the Fight

Cedar River Clinics is suing the Trump Administration to protect the Title X Family Planning Program that provides low- to no-cost family planning and sexual health care services and education to more than 91,000 people across Washington and four million people across the country.  Click here to join us in the fight and support our services.

“While the Trump administration is willing to play politics with people’s lives to pander to a specific ideological base, Cedar River Clinics is committed to protecting reproductive health care and ensuring that patients can continue to receive the high-quality health care they need and have come to expect from us. Helping patients is our primary focus, and we are prepared to fight for our community and communities across the country that rely on Title X,” said Connie Cantrell, Executive Director of Cedar River Clinics.

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Special Offer

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Including IUDs

 

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