Request Your Medical RecordsSutter Health 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the Patient Identification section. Enter your complete legal name, any other names used during treatment, and your birth date. Don’t forget to include your phone number for any follow-up questions.
3. In the Preferred Method of Release section, select how you would like to receive your records by checking either Mail, Fax, or Email.
4. Complete the Requestor Information field with the name of the individual or agency that should receive the information. Include their contact details based on your preferred method of release.
5. Indicate the Purpose of Release by selecting from options such as Personal, Insurance, Legal, etc., ensuring compliance with federal privacy regulations.
6. Check all types of information you wish to disclose in the Information Requested section. Be mindful of sensitive information like HIV/AIDS status and make selections accordingly.
7. Finally, sign and date the form in the Patient Signature section. Remember that a typed signature is not acceptable.

Start using our platform today to easily fill out and submit your medical records request for free!