Medical Records Authorization: Swedish
Please submit your forms by email or fax
We're asking for your help to reduce the amount of paper requests we receive. Please refrain from submitting your forms by mail. Instead, please send by email or fax them to 206-320-2626.
Swedish Medical Center now offers an online payment option to pay for medical records. Please visit our payment portal to make a credit card payment. Thank you.
Swedish is required by law to maintain the privacy of your health information, to provide you with a notice of our legal duties and privacy practices, and to follow the information practices that are described in the Notice of Privacy Practices.
You have the right to receive a copy of your health information that we maintain, with some limited exceptions. You have the right to receive a copy of your health information in a format you prefer (e.g., paper, email, CD, fax, MyChart). You have the right to request that your health information be sent to any person or entity.
Obtain your medical records via MyChart
Patients can obtain copies of electronically-maintained records at no charge directly from your MyChart account. The MyChart secure web portal allows patients to view portions of their medical record, send a message to their care team, view and pay bills, and request copies of medical records.
To sign up for a MyChart account, visit MyChart.
Request access, authorize disclosure via forms or in writing
To receive a copy of your health information, you may complete the Patient Request for Access form, you may write a letter, or if you prefer, you may use the Authorization for Disclosure form:
- Patient Request for Access form (English)
- Patient Request for Access form (English with large print)
- Patient Request for Access form (Amharic)
- Patient Request for Access form (Arabic)
- Patient Request for Access form (Cambodian/Khmer)
- Patient Request for Access form (Chinese simplified)
- Patient Request for Access form (Chinese traditional)
- Patient Request for Access form (German)
- Patient Request for Access form (Japanese)
- Patient Request for Access form (Korean)
- Patient Request for Access form (Laotian)
- Patient Request for Access form (Oromo)
- Patient Request for Access form (Punjabi)
- Patient Request for Access form (Russian)
- Patient Request for Access form (Somali)
- Patient Request for Access form (Spanish)
- Patient Request for Access form (Tagalog)
- Patient Request for Access form (Tigrigna)
- Patient Request for Access form (Ukrainian)
- Patient Request for Access form (Vietnamese)
- Authorization for Disclosure form (English)
- Authorization for Disclosure form (English with large print)
- Authorization for Disclosure form (Amharic)
- Authorization for Disclosure form (Arabic)
- Authorization for Disclosure form (Cambodian/Khmer)
- Authorization for Disclosure form (Chinese simplified)
- Authorization for Disclosure form (Chinese traditional)
- Authorization for Disclosure form (German)
- Authorization for Disclosure form (Japanese)
- Authorization for Disclosure form (Korean)
- Authorization for Disclosure form (Laotian)
- Authorization for Disclosure form (Oromo)
- Authorization for Disclosure form (Punjabi)
- Authorization for Disclosure form (Russian)
- Authorization for Disclosure form (Somali)
- Authorization for Disclosure form (Spanish)
- Authorization for Disclosure form (Tagalog)
- Authorization for Disclosure form (Tigrigna)
- Authorization for Disclosure form (Ukrainian)
- Authorization for Disclosure form (Vietnamese)
If you choose to write a letter, it must include the following required elements:
- Signed by the individual (patient)
- Clearly identify the patient, preferably name and date of birth
- Clearly identify the person designated to receive the records
- Identify what records are to be included
How to submit your request
Swedish Medical Center (all campuses) & Swedish Cancer Institute (all campuses)
Swedish Medical Center
Attn: Health Information Management
747 Broadway
Seattle, WA 98122
Phone: 206-320-3850
Fax: 206-320-2626
Send an email to Swedish Medical Center, Swedish Cancer Institute
Business hours: 8 a.m. - 4 p.m.
Swedish Medical Group Primary & Specialty Care clinics, Express Care Virtual, or Swedish ExpressCare at Walgreens
Please contact us by phone, fax or email to request medical records.
Phone: 206-320-3025
Fax: 478-238-9436
Send an email to Swedish Medical Group Primary & Specialty Care clinics, Express Care Virtual, or Swedish ExpressCare at Walgreens
Swedish Radiology
Please submit the transfer form below or contact us by phone, fax or email to request imaging.
Swedish Image Transfer Form - not for patient use
Patients, please complete the "Patient Request for Access form" at the top of the page and submit it via email or fax.
Phone: 206-320-2201
Imaging request fax: 206-233-7380
Legal request fax: 206-386-2787
Send an email to Swedish Radiology
Processing time
Please allow sufficient time for processing. Turnaround time is up to 15 days according to Washington state law.
Cost
For medical use, there is no fee if records are to be sent directly to a doctor or other healthcare provider for the purpose of continuing care.
For copies for patients or their representatives, there may be a reasonable, cost-based fee.
For copies for other uses, the current rates set by state law may apply.
Payment
For credit card payments, please call 206-320-3850, option 3 or you can pay online using information from your invoice.
Amendment request
Patient Request to Amend a Designated Record Set form
You may write a letter or complete this form to request a correction to your protected health information that was originated or created by a Providence physician.
Accounting of disclosures request
Patient Request for an Accounting of Disclosures form
You may write a letter or complete this form for an accounting of disclosures of your protected health information by Providence Health & Services.
Restriction or revocation request
Patient Release Restriction or Revocation form
You may write a letter or complete this form to restrict the release of your protected health information, revoke a previously signed authorization, or to opt out of Care Everywhere.