Medical Records Request

To request your Providence Regional medical record:

• Download and complete the Authorization for Release of Information Form.
  
• Submit the completed form by mail, fax or hand-delivery:

Mail to:
Providence Regional Medical Center Everett
c/o ROI Department
PO Box 1147
Everett  WA 98206

Fax to:  425-317-0732

Hand-deliver, Monday-Friday, 8 am to 4:30 pm to:
Medical Records Department, Broadway Campus
909 N. Broadway
Everett  WA 98201

Please allow 7 to 10 business days for completion. For the status of your request, call 425-317-0735.

To request your Providence Physician Group medical record:

• Download and complete the ProvPG Authorization for Release of Information Form.
  
• Give your completed form to your doctor's Providence Physician Group office or send via fax. For clinic fax numbers, visit visit Providence Physician Group.

Please allow 15 business days for completion. For the status of your request, please call your doctor’s office directly.