Medical Records Request

Need a copy of your medical records? Our process makes it simple and secure. You can request your records for in-person pickup or have them faxed directly to your designated medical provider. Most requests are processed within 24-48 hours after submission.

STEP #1

Download and Complete the Form

Download the Medical Records Release form, fill out all required fields, and sign the form to authorize the request. Proceed to Step #2 or return this form to the front desk at your hospital.


  • To Avoid delays, ensure all fields are completed, including your signature.
STEP #2

Upload the Signed Form

Use the secure upload form below to submit your completed request.


  • You will receive an email confirmation once your submission has been successfully received
  • If you prefer NOT to upload your form online, you can also return the completed form to the front desk at your hospital location.

Pick Up Records at Your Hospital Location

STEP #3

After submitting your request in Step #2, you’ll receive a confirmation message.  When picking up your records, please bring a valid photo ID to verify your identity. For questions or to confirm the status of your request, contact the phone number listed for your hospital location below.

Bullhead City, AZ

2365 HWY 95

Bullhead City, AZ  86442

(928) 224-2443

Maricopa, AZ

10960 North John Wayne Parkway

Maricopa, AZ  85139

(520) 534-0700

Yuma, AZ

2648 S. Araby Rd

Yuma, AZ  85365

(928) 877-0400

Prescott, AZ

4822 AZ-69

Prescott, AZ  86301

Eloy, AZ

340 E Milligan Rd

Eloy, AZ  85131

Farmington, NM

2670 Pinon Frontage Rd.

Farmington, NM  87402

Ardmore, OK

1641 Woerz Way

Ardmore, OK  73401

(580) 826-3080

Lubbock, TX

6401 Spur 327

Lubbock, TX 79424

(806) 630-4501

Frequently Asked Questions

  • How long does it take to process my request?

    Medical records are typically ready within 24-48 hours after submitting the completed form.

  • How can I check the status of my request?

    You may check the status of your request by calling the front desk of the hospital location you submitted your request to. Each location information is listed in Step #3 above.

  • Do I need to show proof of identification when picking up my records?

    Yes. You will need to provide proof of identification to pick up your medical records at the front desk.

  • Can someone else pick up my records?

    Yes, you can authorize someone to pick up your records by indicating this on your request form. They will also be required to show proof of identification at the front desk.

  • Can my records be emailed or mailed to me?

    For security reasons, records can ONLY be picked up in person or faxed to your designated medical provider.

  • Does it cost to get my medical records?

    Exceptional Community Hospital does not charge patients for a copy of their health records.