Obtaining Medical Records

If you are a current patient of the Care Clinic and would like us to send your medical records to a different provider, we will forward your medical records directly to the provider withing 10 business days. Please fill out the appropriate form.

Si usted es paciente de la Clinica Comunitaria ydesea tener acceso a su expediente medico a solicitar que enviemos copia de su expediente a otro proveedor medico, nostros enviaremos sus expediente medico directamenta a la oficina del doctor en 10 dias. Por favor complete la forma a continuacion:

Form: Authorization for Use and Disclosure of Medical Records (Release of Records)
Form: Autorizacion para revelar y transferir su expendiente Medico

Form: Authorization for Use and Disclosure of Psychotherapy Records (Release of Psychotherapy Records)
Form: Autorizacion para revelar y transferir su expendiente de Salud Mental

If you are not currently a patient of ours but would like to become one, and would like us to get your medical records from your previous provider, please complete the following form. Your provider will respond to our request depending on their timeline policies.

Si usted no es peciente actual de nuestra Clinica pero desea establecer cuidado medico con nosotros, nosotros podemos solicitar su expediente medico a su proveedor medico previo. Su proveedor medico nos enviara una respuesta a nuestra solicitud de acuero a sus politicas internas. Por favor complete la forma a continuacion:

Form: Authorization for Use and Disclosure of Medical Records (Release of Records)
Form: Autorizacion para revelar y transferir su expendiente Medico

Form: Authorization for Use and Disclosure of Psychotherapy Records (Release of Psychotherapy Records)
Form: Autorizacion para revelar y transferir su expendiente de Salud Mental

If you are a current patient and would like to personally review your medical or psychotherapy records, please complete the following form. You have a right to review your records with a provider. Your Care Clinic provider will review your request and contact you.

Si usted es paciente de la Clinica Comunitaria y le gustaria revisar su expediente medico o de salud mental, por favor complete la forma a continuacion. Usted tiene derecho de revisar su expediente medico con su proveedor medico o doctor si lo desea. Su proveedor medico revisara su solicitud y se contactara con usted.

Form: Request for Access

You have a right to review your medical records with a provider’s review. If you have concerns about this, you can review the NOTICE OF PRIVACY PRACTICES . You can also review the United States Health Recourses and Services Administration’s policy on this here: HRSA Privacy Rule.

If you have any questions on your medical records, please contact Stephanie Parme at 970-668-4048 at sparme@summitclinic.org.