MediCopy Request for the Release of Medical Records 2025

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  1. Click ‘Get Form’ to open the MediCopy Request for the Release of Medical Records in our editor.
  2. Begin by filling out the 'Where are the records being released from?' section. Enter the Facility Name, Provider Name(s), and their Address, City, State.
  3. Next, provide details about the patient in the 'Tell us about the patient' section. Fill in their Name, Date of Birth (DOB), Social Security Number (SSN), Email, Address, City, State, Phone Number, and Zip Code.
  4. In the 'Where are we sending the records?' section, enter the recipient's Name, Email, Address, City, State, Phone Number, Fax Number, and Zip Code.
  5. Indicate what records you would like released by checking all applicable boxes. You can also specify dates or other details as needed.
  6. If there are any portions of your medical records you do not want released, check those categories listed under exclusions.
  7. Select a purpose for disclosure from options such as Personal Use or Insurance.
  8. Choose your preferred delivery method for receiving the records: Email, Fax, Pick-up at MediCopy or Postage.
  9. Finally, sign and date the form at the bottom to authorize release. Include your relationship to the patient if applicable.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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The Privacy Rule generally requires HIPAA covered entities (health plans and most health care providers) to provide individuals, upon request, with access to the protected health information (PHI) about them in one or more designated record sets maintained by or for the covered entity.
According to the HIPAA Privacy Rule, your health care provider can take up to 30 days to deliver your health record. However, if you requested a specific delivery date, you may get your record sooner. If your provider needs more than 30 days, they must give you a reason for the delay and a new delivery date.
Medical records are extremely sensitive documents with very detailed information. Even the most minor mistake or omission could cause extended retrieval times leaving you waiting for crucial records. Request forms need to be HIPAA compliant and filled out one hundred percent correctly.
Phone or visit: You can also call or visit your provider and ask them how to get your health record. Ask for the health information services department or the administrative staff in charge of releasing health records.
How long will the process of obtaining medical records take? Once we receive the request, we can typically process the request within 24-72 hours.
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People also ask

Records sent via email or to another provider are complementary. Requests are processed within two (2) business days after receipt by MediCopy.
If you or the person whose records you are requesting on behalf of are unregistered, PCSE will process the access application within 28 days. In certain circumstances, this may not be possible (for example, where the record cannot be traced, or is held by a third party storage provider outside of the control of PCSE.)

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