​Request Medical Records

We follow the law for both federal and state requirements when managing your medical records, billing statements and identity information. We can also provide you with a copy of your information. If you’d like a copy please download the Authorization to Use & Disclose Protected Health Information form, then simply print, sign and mail or fax a copy to us.

Please bring a photo ID when you come to pick up a copy of your medical records. If someone other than you is retrieving the records on your behalf, please make sure the person has a photo ID and an originally signed authorization form granting that person to receive your records from you. You may be charged for the creation of a copy of your records.

If you have any questions regarding your health information, please feel free to contact the Good Samaritan Medical Center's Health Information Department at 561.650.6281.