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Health Forms

Request for Medical Records

To obtain copies of your medical records:

  • Download and complete this Authorization Form.
  • Return to Providence Holy Family:
    • Mail to: Medical Records
      Providence Holy Family Hospital
      5633 N. Lidgerwood St.
      Spokane, WA 99208
    • Fax to: (509) 482-2187
    • Bring the completed form to the Medical Records department, located on the Basement Level of the hospital, near the Cafeteria.
  • Once we receive your request, we are usually able to process it within five days. We may charge a fee for copying your records.

If you are requesting your own records, we will contact you when the copies are ready. You may not request information for a family member unless you are the patient’s legal guardian or if you have power of attorney for that person.

To protect your privacy, we do not to e-mail or fax records to patients. If you have any questions about the status of your request, call (509) 482-2131.

Advance Directives

Advance Directives are documents that allow you to specify the kind of medical care you wish to receive at the end of your life. The first type of Advance Directive is called a Health Care Directive (commonly known as a Living Will). The second type is called a Durable Power of Attorney for Health Care. Both are contained in downloadable document below.

Your wishes do not necessarily need to be documented in an Advance Directive form. They may be documented by your physician in the medical record.