How to Request Copies of Medical Records

COPE Community Services, Inc. maintains a medical record for all patients seen. The release of information from a patient medical record requires proper authorization by the patient or legal representative. Information will not be released, disclosed, or made available for review until the authorization process is completed.

To request a copy of medical and/or billing records, an Authorization for Disclosure of Protected Health Information form needs to be completed. (Download Form) (Spanish). All required information must be completed, including specific dates of service. The records provided will be limited to the information specified on the form.

After completion of the necessary information, including signatures, the form must either be faxed to 520.798.3791, hand delivered, or mailed to:

COPE COMMUNITY SERVICES
Health Information Department
82 S. Stone Ave.
Tucson, Arizona 85701

There may be a charge for the cost of reproduction of medical records. Allow five to 10 business days for processing. Contact the Health Information Department (HID) office to ensure records still exist and have not exceeded the legal timeframe for retaining records.

Contact Information Phone: 520.792.3293 Fax: 520.798.3791

Email: hid@copecommunityservices.org

Office Hours: Monday – Friday; 8:00am – 5:00pm

 

Your Privacy is important, see COPE’s Privacy Notice here (spanish)