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Request Medical Records

Need access to your NMC Health medical records? You can request them by downloading and filling out this request medical records form.

clipboard of patient records with specimen cup and pen

Get access to your medical records

Need access to your medical records? NMC Health’s Health Information Management (HIM) department is available to help you get copies of your file. To request printed or electronic copies of your NMC Health medical records, fill out and sign our Release of Information form.

A valid photo ID is required when submitting the form.

How to submit

Once you’ve filled out the form, you can send it to the NMC Health HIM department by:

  • Fax: 316.804.6261
  • Email: medical.records@mynmchealth.org
  • Mail: NMC Health
              HIM Department
              600 Medical Center Drive
              Newton, KS 67114

Requests are processed within 5-7 business days. Records may be picked up in-person between 8 a.m. and 4 p.m., Monday through Friday at NMC Health’s HIM office, located in the bottom of the NMC Health Surgery Center.

Records can only be released to the patient requesting them or the person specified under Section 2 of the release of information form. A valid photo ID is required for pickup.

Records may also be mailed to the patient or faxed to a physician.

How to fill out the form

Fill out the form by providing the following required information in each section:

  • Section 1: Basic demographic information for the patient whose records are being requested
  • Section 2: From whom the records need to be released (most likely from NMC Health)
    • Specify who needs to get the records (i.e. self, physician, insurance, spouse, attorney, etc.)
  • Section 3: Explain why you need the records (i.e. personal, continued medical care, legal, etc.)
  • Section 4: Verify how you’d like to receive the forms
    • Include the date range or specific dates with year that the treatment or services were performed
    • Include the type of record requested
  • Section 5: Please read, print, sign and date the form

Allowable charges for record copying 

Effective January 1, 2011 the charges may not exceed $18.40 for supplies and labor, plus $0.61 per page for the first 250 pages, and $0.44 per page thereafter. 

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