Request Medical Records
How to Request Copies of an Avista Adventist Hospital Medical Record:
- Complete Patient Request to Access Medical Records and Patient Authorization to Dislcose (available below in both English and Spanish versions)
Patient Request to Access Medical Records
Patient Request to Access Medical Records(Spanish)
Patient Authorization to Disclose PHI
Patient Authorization to Disclose PHI (Spanish)
* NOTE: Provide a copy of your photo ID with the Authorization
- Mail, Fax, or bring the Authorization to the Medical Records Department:
Medical Records, Release of Information Desk
100 Health Park Drive, Second Floor
Louisville, CO 80027
Fax Number for Avista Adventist Hospital Medical Records Department: 303-673-1026
- The HIM department will process requests as soon as possible, 10-14 business days is average.
- If medical record information is needed for continuing care and will be sent directly to a provider, no copy charges apply.
- Copy Charges: A fee for medical record copies may apply in accordance with Colorado State Statues. The copy service will send an Invoice to the requester, upon payment, records will be mailed per the request.
- We limit faxing medical record information to anyone except continuing care providers. Faxing is also limited to the minimum necessary and does not apply to 'entire' record requests.
- An incomplete request will result in delays.
If you have questions call 303-673-1220, Option 1