ATTENTION: HIM Release of Information (ROI) is NOT on-site at the main hospital. Please use the contact information below to reach ROI by phone, email, fax or mail.

Health Information Management
If you need any of the following services, please download the appropriate form, fill it out, date and sign it, then return to us by one of the methods listed below:

  • Release of Information Authorization / Medical Records Request is required to send your medical record from either the hospital or the clinic to a third party (i.e. another provider, your spouse, a family member, insurance company, etc.) or if you would like your treatment staff at VMC to speak with an individual other than yourself about your care (i.e. neighbor, friend, etc.) There is a per page copy fee associated with obtaining a copy of your medical record for personal, legal or insurance use. You will not be charged for medical records copies sent directly to a physician, clinic, hospital or other health care provider. You may also have your records released directly into MyChart at no cost to you. For additional information on how to sign-in or sign-up for MyChart, click here.

 

  • Proxy Access
    • Valley Medical Center recognizes the need for proxy access, which allows a parent or guardian to log in to their personal MyChart account and then connect to information regarding their family member. Proxy access is allowed for patient ages 0-12 years old (up to the day before their 13th birthday). Parents and legal guardians who already have proxy access will be automatically rolled over to limited access when the patient turns 13. Parents and legal guardians who already have proxy access will be termed when the patient turns 18.

      Please follow the below steps to request Minor Proxy Access:

      Minor & Adolescent Proxy Access (0 to 17 years old)  – Parent/Legal Guardian will submit their request through MyChart
                     1. Go to Menu  > Under the Sharing section > Click Request Access to a Minor’s Record
                     2. Read and accept the proxy access terms and conditions
                     3. Click the “Submit Request”

      At age 18, patients can choose to allow adult family and friends full access, access for scheduling purposes only, or limited access to view and perform messaging and scheduling functions. Adult patients with their own MyChart account can request proxy access to another adult directly from their own MyChart account. From the "Profile" tab, click "Proxy/Photos" and then click the link to the "Adult Proxy Request Form" or you can “Go to Menu”, click “Share My Record” then select Friends and Family Access. Follow the instructions to send instructions to send an email invitation to the person who the patient would like to have access to their MyChart account.

     
  • Amendment Request (For Fillable PDF, click here) to amend or change a part of your medical record. The amendment must be approved by the provider before it is included in your medical record.

  • Request for Additional Protection (For Fillable PDF, click here) if you would like additional security measures to be added to your electronic medical record.

  • Epic Care Everywhere Patient Opt Out (For Fillable PDF, click here) if you do not want your health information to be shared with your treating provider(s) through Epic Care Everywhere.

 

Options to Submit Completed Forms

  • Mail to:
         HIM/Records Request
         Valley Medical Center
         400 S. 43rd Street
         Renton, WA 98055
  • Fax to the HIM office at 425.690.9407
  • Email to RecordsRequest@valleymed.org

 

Hours of Operation

  • Monday - Friday, 8AM - 4:30PM
  • Closed for lunch from 1-2PM
  • Closed for VMC Observed Holidays

** Please allow up to 15 business days for processing **

For inquiries about your medical records, contact us by email or call 425.690.3406.

Click here to access your MyChart account.