To request records sent to or from the office please complete and submit the appropriate form below (please allow 10-14 days for your request to be processed):
- Records release from ORH – PDF file
- Records release to ORH – PDF file
ORH Disclaimer Notice for Medical Records Release
Overlake Reproductive Health keeps a record of the health care services we provide you. You may ask to see a copy of that record as well as ask to correct that record. This health care facility will not disclose your records to others unless directed by you through a medical records released form or unless authorized or compelled by law to do so.
Overlake Reproductive Health requires a two week period for authorized records to be copied. This health care facility also requires a copying fee for this service unless otherwise determined by a representative of Overlake Reproductive Health. The schedule of charges below is in compliance with the Washington State Uniform Health Care Information Act RCW 70.02.070, Section 102(12), WEAC 246-08-400, effective July 1, 2005. An authorization does not need to be honored until the fee is paid in full.
The fees* are as follows:
$1.02 per page for the first 30 pages
$0.78 per page for all additional pages
$23.00 clerical fee for records requested by parties other than the patient
Washington Sales Tax and all appropriate shipping & handling
You will not be charged for medical records sent to a physician we are referring you to for additional medical attention. Unless we are notified up front that all records are required, ORH will only send the most recent two years of your file.
*Fees are subject to change without notice, for the most current fees please contact us.
