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Medical Records Request

To request your Providence Regional medical record:

Download and complete the Authorization for Release of Information Form.

Submit the completed form by mail, fax or hand-delivery:

Mail to:

Providence Regional Medical Center Everett
c/o ROI Department
PO Box 1147
Everett, WA 98206

Fax to:

(425) 317-0701

Hand-deliver, Monday-Friday, 8 am to 4:30 pm to:

Medical Records Department, Broadway Campus
909 N. Broadway
Everett, WA 98201

Please allow 7 to 10 business days for completion. For the status of your request, call (425) 317-0735.

To request your Providence Medical Group medical record:

Download and complete the Providence Medical Group Authorization for Release of Information Form.

Give your completed form to your doctor's Providence Medical Group office or send via fax. For clinic fax numbers, visit Providence Medical Group.

Please allow 15 business days for completion. For the status of your request, please call your doctor’s office directly.