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The Health Information Services Department at Northside Hospital, which includes the Medical Records Department, is committed to protecting your privacy and also to giving you timely, accurate access to your medical records when you need them. Please refer to the HIPAA Notice of Privacy Practices for more information. 

There are several ways you can request your Medical records: 

erequest

E-Request

You may e-request copies of your medical record via a secured website hosted by our release of information vendor MRO.

Request Records Here
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Paper request

Download and print an Authorization form for the Release of information. Email your completed request to [email protected]. You may fax or mail your request to a Northside Health Information Department.

 

myonechart

MyOneChart

Northside Hospital is pleased to offer our patients easy, secure and convenient access to their personal health information via Northside's MyOneChart online portal.

MYONECHART PORTAL

Documents and Forms

DescriptionDownload
Authorization for release of medical records and information
Signing this form allows Northside to share a patient's protected health information (PHI) with specified individuals or organizations, according to the details stipulated in the form by the patient.
English
Request for Amendment to health information
This form allows patients to request a change, edit, or update on their health information record maintained by Northside.
English
Request for accounting of certain disclosures of protected health information
This form allows patients to receive an accounting of disclosure of their health information that was made for purposes other than treatment, payment, or health care operations.
English
Request for limitations and restrictions of protected health information
This form is used to restrict the use and/or disclosure of patient’s health information by Northside. This form is not applicable during emergency treatments.
English
Have Questions?
Have questions about how to request medical records?
Find answers on our Frequently Asked Questions page.
View FAQS
.