Request Medical Records

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There are three ways to request your medical records from Northwest Health - La Porte:

1. Your doctor can call or fax a request for your medical records. All requested records will be sent directly to the office. There is no charge for this service.
2. Your attorney can submit a request to have the records delivered to their office. This is necessary for the records to be admissible in court. Please note there is a fee for this service, including an additional fee if the request requires immediate processing. A signed authorization is required.
3. You can request the records yourself. Please note there is a charge to fulfill a direct request.

To personally request a copy of your medical record, follow these steps:

1. Fax or mail your completed Authorization for the Release of Information form along with a legible copy of your state-issued photo identification. If you prefer, you may bring the completed authorization to the Medical Records Department at Northwest Health - La Porte and request your records in person. (Bring photo identification with you.)
2. The Medical Records staff will verify your identification* and inform you of the nominal processing charge based on the number of pages requested. If your request is not in person, you will be notified of the fee by mail.
3. Once we receive your payment for records, they will be ready for pick up or mailed in five working days. You may expedite your request for an additional fee as stated above.

If we are unable to verify your signature with that on file or your photo ID is not legible, we reserve the right to require a notarized signature or re-submission of legible photo identification.

Medical Record Request - English
Medical Record Request - Spanish

For more information, or to request a copy of our fees, please contact the medical records department at (219) 326-2331.