Medical Records Request

Submitting your own request for medical records in writing
In order to complete your hand written request for medical records, the Health Information Management (HIM) department will need you to include the following information:

  • Patient name
  • Patient address
  • Patient date of birth
  • Date of service
  • Specific information requested
  • A copy of your (the requester's) photo ID and contact information

Examples of information that can be requested:

  1. Entire medical record
  2. Discharge summaries
  3. History and physicals
  4. Operative/procedure reports
  5. Laboratory reports
  6. Medical imaging reports or films
  7. Emergency Room reports
  8. Pathology reports
  9. Progress notes
  10. Billing records
  11. Nurses notes
  12. Physical therapy records
  13. Patient education records
  14. Clinic notes

Please list a separate and specific authorization in your request if you would like us to include a medical record on any information related to the following:

  1. HIV/AIDS
  2. Drug and alcohol use or treatment
  3. Psychiatric disorders/mental health
  4. Sexually transmitted diseases

Lastly, please specify a length of time you would like your request to be considered. If no date is specified, your request will automatically expire in 90 days.

If you have any questions or need help in completing your request, please call Health Information Management at 360-744-6600.

Mail request to:
Harrison Medical Center
Health Information Department
2520 Cherry Avenue
Bremerton, WA 98310-4207

For continuing care fax your request to 360-744-6607.

For all other requests fax your request to 360-744-6918.

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