Crisis Intervention Services are available 24 hours a day by calling, toll-free 1-800-621-8504
Behavioral Health & IDD Centralized Intake 1-800-669-4166

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Request Records

MEDICAL RECORDS REQUEST

How do I request a copy of a medical record?

Download form here.

You can request a copy of a medical record by completing an Authorization to Release/Exchange Information form and submitting it to the Medical Records Department.

Who is authorized to sign for release of information (get a copy of a medical record)?   

The following people are authorized to sign for release of information:
• The consumer/client (Not the spouse.)
• Power of attorney, if patient is unable to sign (Documentation must be provided.)
• Parent (If the consumer/client is under the age of 18.)
• Parent and minor (If the consumer/client is 12-17 years of age. This is for records relating to psychiatric, alcohol, or drug treatment services.)
• Legal guardian (Proof of guardianship documentation must be provided.
• Representative of the estate for deceased consumer/client (Copy of the death certificate and a copy of the representative of estate documents must be provided.)

 

When will I receive a copy of the medical record?

The Medical Records Department receives a large number of requests and many of the records requested are very complicated. Your request will be processed within 15 business days.

 

Who do I contact if I have questions?

If you have any questions, please call the Medical Records Department at:
(940) 720-3516.

Our mailing address is:
Helen Farabee Centers
Medical Records Department
P.O. Box 8266; 516 Denver
Wichita Falls, TX 76307-8266