Your Records in Three Easy Steps
Click the “Get Started” button below to begin your record request.
Find our portal login email within 1-2 business days and complete the form(s).
Access your records via preferred method in 7-15 business days.
FAQs
Once you submit your request for records, you will get an email confirmation sent from recordrequest@requestmyrecords.com. After verifying your request, we will get back to you within 1-2 business days to provide additional instructions. If you have not heard from us within the time frame specified, please check your spam folder for the message.
You will receive your records approximately 7-15 business days after your Authorization Form(s) are processed.
Requests for records will be fulfilled on the secure RequestMyRecords portal, unless an alternative delivery method of secure email, efax or United States Postal Service is selected as an option on the Authorization Form(s).
Once we receive your records request and process the Authorization Form(s), an email notification with instructions for establishing a secure RequestMyRecords portal login will be sent from recordrequest@requestmyrecords.com.
Yes, you can request records via phone or email. However, submitting the Record Request Form is the safest and most efficient request method recommended.
Medical records may be requested by phone at 574-314-9300 or by email at medicalrequest@requestmyrecords.com. Please see the FAQ below for instructions on how to make a medical record request via email.
Employee records may be requested by phone at 574-314-9300 or by email at employeerequest@requestmyrecords.com. Please see the FAQ below for instructions on how to make a medical record request via email.
The records request process may be less secure and efficient if completed via phone versus by the secure RequestMyRecords portal. It is highly recommended that the portal is utilized so that a full audit trail may be documented to protect your information. You should never share your personal information such as date of birth or social security number over the phone.
The records request process may be less efficient if completed via email versus by the secure RequestMyRecords portal. It is highly recommended that the portal is utilized so that a full audit trail may be documented to protect your information. You should never share your personal information such as date of birth or social security number over email.
Please email medicalrequest@requestmyrecords.com and use the below email template including the Subject line information. *=required field
Subject: Medical Record Request – Patient requestor
Body of Email
Patient Information
- First Name*:
- Middle Name or Initial:
- Last Name*:
- Maiden or Other Name:
- Gender (Male, Female, Prefers Not to Answer):
- Date of Birth* (MM/DD/YYYY):
- Mailing Address*
- Street Address:
- City:
- State:
- Zip Code:
- Country:
- Email Address* (hello@world.com):
- Phone Number* (XXX-XXX-XXXX):
- Name of Facility/Entity where your records are located*:
Additional Information – Please provide any additional information to help us verify and process this specific record request.
Please email medicalrequest@requestmyrecords.com and use the below email template including the Subject line information. *=required field
Subject: Medical Record Request – Third-party requestor for a Patient
Body of Email
Patient Information
- First Name*:
- Middle Name or Initial:
- Last Name*:
- Maiden or Other Name:
- Gender (Male, Female, Prefers Not to Answer):
- Date of Birth* (MM/DD/YYYY):
- Mailing Address*
- Street Address:
- City:
- State:
- Zip Code:
- Country:
Third-party Information
- Type of Third Party* (Parent or Legal Guardian, Physician, Attorney, Payor, Government entity, Other – Please explain):
- Your Entity/Organization Name* (if not the Parent or Legal Guardian):
- Your Relationship to Person:
- Your First Name*:
- Your Middle Name or Initial:
- Your Last Name*:
- Your Email Address* (hello@world.com):
- Your Phone Number* (XXX-XXX-XXXX):
- Your Fax Number* (XXX-XXX-XXXX):
- Your Mailing Address*
- Street Address:
- City:
- State:
- Zip Code:
- Country:
Additional Information – Please provide any additional information to help us verify and process this specific record request.
Please email employeerequest@requestmyrecords.com and use the below email template including the Subject line information. *=required field
Subject: Employee Record Request – Employee requestor
Body of Email
Employee Information
- First Name*:
- Middle Name or Initial:
- Last Name*:
- Maiden or Other Name:
- Gender (Male, Female, Prefers Not to Answer):
- Date of Birth* (MM/DD/YYYY):
- Mailing Address*
- Street Address:
- City:
- State:
- Zip Code:
- Country:
- Email Address* (hello@world.com):
- Phone Number* (XXX-XXX-XXXX):
- Name of Facility/Entity where your records are located*:
Additional Information – Please provide any additional information to help us verify and process this specific record request.
Please email employeerequest@requestmyrecords.com and use the below email template including the Subject line information. *=required field
Subject: Employee Record Request – Third-party requestor for an Employee
Body of Email:
Employee Information
- First Name*:
- Middle Name or Initial:
- Last Name*:
- Maiden or Other Name:
- Gender (Male, Female, Prefers Not to Answer):
- Date of Birth* (MM/DD/YYYY):
- Mailing Address*
- Street Address:
- City:
- State:
- Zip Code:
- Country:
Third-party Information
- Type of Third Party* (Business, Attorney, Payor, Government entity, Other – Please explain):
- Your Entity/Organization Name* (if not the Parent or Legal Guardian):
- Your Relationship to Person:
- Your First Name*:
- Your Middle Name or Initial:
- Your Last Name*:
- Your Email Address* (hello@world.com):
- Your Phone Number* (XXX-XXX-XXXX):
- Your Fax Number* (XXX-XXX-XXXX):
- Your Mailing Address*
- Street Address:
- City:
- State:
- Zip Code:
- Country:
Additional Information – Please provide any additional information to help us verify and process this specific record request.
Medical facilities and employers often partner with an outside organization to fulfill release of information requests to save their organization time and resources as well as to ensure records are stored securely.
Yes, RequestMyRecords uses HIPAA-compliant cloud storage to securely retain and deliver records, complying with state and federal records management regulations.
RequestMyRecords will store your records in accordance with your medical facility or employer record retention and destruction policy.
Harmony Healthcare IT, a health data management and records release firm, has been selected by medical facilities and employers to securely store and manage information on their behalf.
Once you submit your request for records, you will get an email confirmation. After verifying your request, we will get back to you within 1-2 business days to provide Authorization Form(s). You will fill out and submit Authorization Form(s) to us. After we process the Authorization Form(s), we will provide access to your records as soon as we are able (no later than 7-15 business days). Submitting multiple record requests or Authorization Forms may slow the process. Should you need to reach us on the status of your record release fulfillment, please call 574-314-9300 and select option three for support.