Virginia Mason is happy to provide a copy of your health information at no cost to you. Examples of individual documents include:

• Notes and records about a particular condition
• Hand written or dictated progress notes for treatment dates
• Consultation
• Operation report(s)
• Pathology and lab reports(s)
• X-ray reports
• Physical or Occupational Therapy notes
• Outside records
• Other specialized tests, such as: angiography, cardiac catheterization procedure, stress test (treadmill), EKG (electrocardiograms), EEG (electroencephalograms), magnetic resonance imaging (MRI), myelogram, nuclear medicine scans (CT scans)

Medical Records Forms

To request copies of your records, please fill out and return the Virginia Mason Authorization to Release Patient Health Information form. You will need to fill out the authorization completely. Please make sure that you provide us with the following information:

• Unique patient identifiers (i.e. name, birth date)
• Name of provider or organization authorized to make the disclosure (i.e. Virginia Mason or a Virginia Mason physician)
• Name of the person or organization to whom Virginia Mason may release information
• Description of the specific information to be released
• Description of the purpose or need for information
• Signature of the individual (patient or legally authorized representative) and date

All Release of Health Information (Medical Records) Patient Forms

• Authorization to Release Patient Health Information (medical records request) 
    
• Bailey-Boushay House Authorization for Release of Patient Health Information  
   
• Authorization for Release of Mammogram Films
  • Hospital & Seattle Medical Center, Bainbridge Island Medical Center, and Bellevue Medical Center
  • Kirkland Medical Center and Lynnwood Medical Center
  • Issaquah Medical Center
  • Federal Way Medical Center

Please print the forms and drop off or mail them to the appropriate Release of Information department, as listed in the instructions.

Contact Release of Information (Medical Records)

If you have any questions, please contact the appropriate Release of Information Department, as listed below: