Medical Records

Request medical record copies:

Please complete Release of Information Authorization (ROI) form with as much information as possible, including a phone number in case additional information is needed.

Please note:

• You may only request copies of your own records.
• For requests of records for another patient you must have legal documentation indicating active representative or an ROI on file currently.
• For minor children, you must be listed as the guarantor on their account or show legal custody documents.
• If you wish to have an ROI filled out for another patient, that patient must sign release in person at our office.
• Records requests will be reviewed and a response of processed or denied with reason as soon as possible. Depending on request, it may take one to two weeks to process. Most are completed sooner.
• JCHC does follow Wyoming State Retention schedule when archiving medical records.

If faxing or mailing the authorization please provide two forms of ID. A photo ID is required (driver’s license) and at least one other form of ID such as a copy of your social security card or birth certificate. When faxing, you may need to lighten your ID in color as it will come across unreadable.