Northern Arizona Healthcare has partnered with Sharecare to fulfill your records requests.
Northern Arizona Healthcare is committed to protecting your medical information. For information about your rights and the obligations you have regarding the use and disclosure of your medical information, please see our Notice of Privacy Practices.
Please follow the instructions below to request medical records for yourself or someone else. We require a valid email address and a government-issued ID in order to request these records electronically.
How to submit
- The fastest way to request medical records is by submitting an online form.
- Patient and/or Legal Guardians – This Sharecare form is for patients and legal guardians with legal paperwork to request copies of medical records.
- Other Legal Representations – This Sharecare form is for health care providers, attorneys, and anyone requesting the medical records of someone other than themselves or a legal guardian.
- If you cannot complete the electronic form, please download and complete the paper authorization form.
- Use this form to request the medical records in English
Authorization to Use or Disclose Protected Health Information English - Use this form to request the medical records in Spanish
Authorization to Use or Disclose Protected Health Information Spanish - Please make sure the form is readable and complete. Unreadable or incomplete forms will not be processed.
- You may submit the completed form by fax to 866-381-5303.
- You may mail in the completed form to:
- Flagstaff Medical Center at Northern Arizona Healthcare
Health Information Management
Medical Record Requests
1200 N. Beaver St. Flagstaff, AZ 86001
- Flagstaff Medical Center at Northern Arizona Healthcare
- Use this form to request the medical records in English
FAQ
How do I check the status of my request?
How do I pay for my records and/or radiology images?
How do I contact customer service?
Call 978-922-0016
When will my request be processed?
- Records are usually available within 10 days from the time the request is received. If you are picking up your medical records in person, please be sure to bring a government-issued ID.
- If another person will pick up the records for you, please indicate who that will be on the authorization form. They will need to present their government-issued ID.
Who can pick up the records?
Only the patient, parent/legal guardian, or the patient’s legal health care representative can request medical records. If you are requesting records on behalf of a patient or as a patient’s representative, please provide a copy of an Advance Directive/Durable Power of Attorney for Healthcare Conservatorship.
Where do I pick up my records?
Flagstaff Medical Center at Northern Arizona Healthcare
Health Information Management kiosk
1200 N. Beaver St.
Flagstaff, AZ 86001
Phone: 928-773-2072
Fax: 928-773-2178
Email: [email protected]
Verde Valley Medical Center at Northern Arizona Healthcare
Health Information Management
Medical Record Requests
269 S. Candy Lane
Cottonwood, AZ 86326
Phone: 928-639-6280
Fax: 928-639-6030
Email: [email protected]