Medical records

As a patient, you have the right to receive copies of your medical records from MultiCare Rockwood Clinic. 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 an Authorization to Use and Disclose Protected Health Information form.

• Download the authorization form – English
• Download the authorization form – Spanish
• Download the authorization form – Russian
• Download the authorization form – Vietnamese

To hand-deliver this form, visit any Rockwood Clinic location, Monday to Friday, 8am-5pm, or call 509-838-2531.

To mail, send this form to:

MultiCare Rockwood Clinic
P.O. Box 3649
300 East 5th Ave.
Spokane, WA 99220

You may fax this form to:
MultiCare Rockwood Clinic Release of Information Department
Fax: 509-342-3962

Charges for copies of medical records

Rockwood Clinic has partnered with CIOX Health, the nation’s largest provider of release of information services, to process and fulfill your request for a copy of your medical record. 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 Health would like you to know that there is a charge for this service and prepayment is required. Due to the strict procedural and highly regulated steps in the process, known as the release of information process, there are costs associated and, therefore, a fee is charged for this service as outlined below:

• Electronic records delivered in electronic format: $6.50
• Electronic medical record with paper records, with paper records delivered in electronic format: $6.50 + $0.07 per page, labor cost to create and deliver the medical record
• Electronic records delivered in paper: $0.90 per page labor cost plus $0.05 per page for paper and toner
• Paper records delivered in electronic format: $0.07 per page labor fee
• Paper records delivered in paper format: $0.12 per page
• Plus postage and taxes

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.

Please note: Radiology does charge an additional $6.50 for images that are put onto a CD per patient request. Please contact MultiCare Rockwood Clinic Imaging regarding any request for radiologic images. Imaging can be reached at 509-342-3581. Please allow up to three business day for processing.

If you have any questions, please call our Release of Information Department at 509-838-2531.

If you have further questions about protected health information, please see our Notice of Privacy Practices.