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Records Requests
Click on the blue document link to open and print.
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RELEASE OF INFORMATION:
In order to obtain records from Edina Family Physicians or an Allina
facility, you need to fill out a Release of Information form or
Authorization to Release and
Disclose Patient Information form.
Please fill out this document in blue or black ink pen, write legibly
and fill in each required field.
Each section is required to be
filled out completely in order for the "Authorization" to be accepted
and fulfilled.
If you have any questions filling out this form -
see the second page for instructions.
You can also call the Allina
Commons HIM team at 612-262-2300 and they can answer any questions you
may have.
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For all records request: Transfer of Records, Records to
another Physician, Insurance purposes, etc... |
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Fill out the release of information form
Fax to
612-262-2323
or mail to:
Allina Health
PO Box 43
Minneapolis, MN
55440-0043
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To
request
records from MyAcount |
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- Login to your
MyAccount
- Click on Health Record (MyChart)
- Click on the Request Health Record account link
on the right hand side of the page
- All questions call 612-262-2300
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