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Medical Records

Director: Becky Farrell, 303-498-1659
Phone: 303-498-1640
Fax: 303-498-1677

 

Medical Records Release of Information Consent Form (CLICK TO OPEN)

 

Medical Records Release of Information Consent SPANISH Form (CLICK TO OPEN)

 

If you would like a copy of your legal medical record, our Health Information Management Department (HIM) is happy to assist you. Their office is located on the first floor of the Medical Center and they are open Monday through Friday from 8:00 a.m. to 5:00 p.m. The HIM department maintains all medical records with integrity, security and confidentiality of all patient health information.

Copies of medical records may be obtained one of the following ways:

1. You may print and fax or mail the release of information authorization form (above).  The form needs to be filled out completely and returned to the HIM department. This may be faxed to the HIM Department at 303-498-1677 or mailed to 1600 Prairie Center Parkway, Brighton, CO 80601. The release must be accompanied with a copy of a picture ID of the person signing the release and a contact telephone number. Records will be mailed back to the requesting party. If the release is not filled out completely this will result in a delay to you receiving your records.

2. You may bring your completed release of information authorization form directly to the HIM Department.  Please bring a picture I.D. with you for identification purposes.

3.  If records are being requested by someone other than the patient, please provide proper documentation proving the right to patient’s medical records, such as a Health Care/Medical Power of Attorney, death certificate, guardianship, etc.  The person listed in these documents must sign on the 2nd page and note on the last line what the basis for legal authority to sign the authorization by a personal representative is, such as parent, guardian, etc.

4. Requests will be completed while you wait if there are only a few pages that are needed.  If there is a larger volume we will arrange with you for the records to either be mailed or picked up at a later date.

Health Information Management Department contact information:
Platte Valley Medical Center
HIM Department
1600 Prairie Center Parkway
Brighton, CO  80601
Phone: 303-498-1640

Fax: 303-498-1677

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April 18 2014

 

04/16/2014

Planetree Names PVMC One of the World’s Most Patient Centered