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Medical Records and Forms

Request Copies or Authorize Release of Your Medical Records

As a patient, you have the right to receive copies of your medical records from MultiCare Deaconess Hospital. In order to obtain copies of your records or to authorize release of your medical records to another party, you must complete, sign and date the “Authorization to Use and Disclose Protected Health Information” form. Please see the link below to download this form.

Download the Authorization to Use and Disclose Protected Health Information form.

Obtener el formulario de autorización en español

To hand-deliver your completed form, visit the Health Information Department:

MultiCare Deaconess Hospital
800 W 5th Ave.
Spokane, WA 99204
Monday-Friday, 8am-4pm
509-473-7421

The department is located on the first floor of the hospital near the Comprehensive Wound Healing and Hyperbaric Chamber Center

You may also fax your completed form to the Deaconess Health Information Department at 509-473-7522

Charges for Copies of Medical Records

MultiCare Deaconess Hospital contracts with CIOX Incorporated, a professional medical record copying service, to ensure that your copies are available to you as quickly as possible. Please allow up to 15 business days for us to process your request, even though we strive to make the copies available within three business days.

Prior to copying your records, CIOX Incorporated would like you to know that there will be a reasonable fee charged for this service and pre-payment may be required.

The ability to charge for copying of medical records, to cover the costs of labor and supplies, is mandated by the Washington State Legislature as outlined in RCW 70.02.

We often recommend that you request only the pertinent parts of your medical record in order to limit the number of pages copied. This usually includes all of the medical reports documented by the physician (such as, discharge summary, operative reports, consultation reports) and relevant progress notes from your visit and diagnostic tests (such as, Lab, Radiology, EKGs). CIOX Incorporated will contact you with the pre-payment amount. Medical records will not be released until pre-payment is received.

If you have any questions, please contact the Deaconess Health Information Department at 509-473-7421.

Patient Portal

My Health Home patient portal is a free and secure online home for your inpatient hospital health information related to your care at MultiCare Deaconess Hospital.

My Health Home