Patient Medical Records Request Form

The privacy and confidentiality of our patient’s personal heath information is very important to us at Norman Regional. The patient or patient’s legal guardian will complete the following form to authorize access or disclosure for the patient’s protected health information. This form will allow us to release the patient’s health information for continued treatment, insurance/payment, legal, or other purposes.

Download Medical Records Request Form

Please print, complete the entire form, and return to the Health Information Management Department by any of the following methods:

  • Fax to ATTN: HIM Department @ one of the fax numbers listed below.
  • Mail to ATTN: HIM Department @ 901 N. Porter Ave., Norman, OK 73071.
  • Personal Delivery – The HIM Department accepts release of information record requests 8 a.m. to 5 p.m. Monday – Friday.

The HIM Department accepts patient record requests at any of our campus sites, not specifically to the location in which services were rendered.

Porter Campus:
901 N. Porter Ave., Norman, OK 73071
Phone: 405-307-1366
Fax: 405-307-1360

HealthPlex:
3300 HealthPlex Parkway, Norman, OK 73072
Phone: 405-515-1366
Fax: 405-515-1360

Please contact the HIM Department at 405-307-1366 if further assistance is needed. 

To request an amendment to your medical record please contact the Patient Liaison at 405-307-1060, by mail or by EMAIL. For email requests, please include the patients name, date of birth, date of service and detailed information as to what documentation needs to be corrected along with contact information.