Northern Arizona VA Health Care System

 

Request Your Medical Records

Request Your Medical Records

Our Release of Information staff will be happy to assist you with requests for your medical records. They are also experts in patients' rights. We also assist providers with completing forms for patients. We can assist you with the following:

  • Access to your medical records
  • Oobtaining copies of your medical records
  • Requests to amend your medical records
  • Completion of forms for benefits, insurance, and other reasons

How to Request Information

To request a medical record, please one of the forms listed in the column to the right, complete the requested information, sign the form, and mail it to the following address:

  • Northern AZ VA Health Care System
    Patient Business Office
    Release of Information
    500 Hwy 89N
    Prescott, AZ  86313

Because forms must contain an original signature, e-mailed forms cannot be accepted.
Depending upon the request, medical could take up 10-14 days to process.
Consent or authorization for release of information by a specific individual, physician or insurance company allows the hospital to send copies of information contained in a patient's medical record to another provider who may also be treating the patient, to other agencies/organizations for benefits consideration, or to the patient him/herself.

Fees

There is no cost to send copies directly to another health care provider. If copies are for a patient's personal use, photocopying fees may be assessed.
Contact Information
The Release of Information supervisor may be contacted by calling (928) 445-4860 ext. 6227.