Health Records Request

Health Records

About Health Records

If you have questions about obtaining health records for yourself or a third party, please contact us by clicking the buttons below.

Request Your Health Records

You, a parent, legal guardian or personal representative can request access to your health records.

To request a copy of your health records, download the form (available in both English and Spanish), read the information provided, then follow the instructions on how to submit the form titled: Request for Access to Protected Health Information.

The form must be completed and signed for us to process your request.

Click here to download the Health Records Request Form in English.

Haga clic aquí para descargar la forma en Español.

Authorization to Release Health Records to a Third Party

To release copies of health records to third party entities such as hospitals, primary care providers, attorneys, etc., download the form Authorization to Release Confidential and Protected Health Information.

The authorization form must be legible, complete and signed to release health records to third party entities.  The completed form can be faxed to 303-504-6504 or emailed to HISM@wellpower.org.

Click Here to download the form in English.

Haga clic aquí para descargar la forma en Español.

Pay For Your Records

Once we receive your request and approve it, you will receive an invoice for the cost of processing your request. Please follow the instructions on the invoice on how to make payment or call 303-504-6510 with any questions.

Contact Us

Address:
WellPower
Health Information Systems Management
4141 E Dickenson Place
Denver, Colorado 80222

Phone: 303-504-6510
Fax: 303-504-6504
Email: HISM@wellpower.org
Hours: Monday to Friday, 8 am to 4:30 pm