Obtaining Your Medical Records

You may request photocopies of your medical records from the Medical Records department at the hospital where you were a patient. A completed release form signed by you or by your legal guardian is required. Click on the form below. Fill it out completely and mail or fax in to the LMHS hospital you were a patient. Proper identification will be required to pick up the records.
Authorization for Release of Medical Record Information #1062

To be used when a LMHS patient is requesting that their protected health information be released to another provider entity or external requestor (requires patient signature).

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