Due to COVID-19 restrictions, Medical Records is closed to in-person assistance, however, staff is still available to assist patients by phone,
Monday - Friday, 8 a.m. to 4:30 p.m. at (360) 299-1326 or email at email@example.com.
Medical Record Request
For an Island Hospital medical record request, please follow the instructions below:
1. Print an Authorization to Disclose/Obtain Protected Health Information (PHI) form.
2. Mail, email or fax the completed form to:
Medical Records Department
1211 24th Street
Anacortes, WA 98221
F: (360) 299-1347
Here is what is required on the form.
To be valid, the Authorization to Disclose/Obtain Protected Health Information form needs to be in writing, dated, signed BY THE PATIENT, and must contain the following information:
- From whom the information is to be released (Island Hospital).
- To whom the information is to be released.
- The purpose of the release (box needs to be checked - usually personal).
- What information the patient is requesting needs to be noted.
- The time period when the service was performed. If you can't remember exactly, providing a general time frame gives us a hint (example: July 2018).
- Contain an expiration date (example: one week from today).
- Be signed and dated by the patient.
Spouses generally CANNOT sign for each other. There are, of course, circumstances involving guardianship, minors, Durable Power of Attorney for Health Care (which is only applicable if the patient is unable to sign for themselves), etc. The age requirements for diagnoses involving mental health, alcoholism, drug abuse, pregnancy/pregnancy termination, sterilization, or sexually transmitted disease including HIV/AIDS, are listed on the form.