Medical Records

Fees:

All records for a requesting physician are free, but must be requested by the physician’s office.

Records requested for personal use are as follows:

Pages 0-10 are free. Any requests over ten pages are $10 + $.50/pg.

To expedite a records request, the cost is an additional $10.

Processing Time:

Requesting Physicians – Immediately

Personal, Lawyer, or Insurance – 10-15 days

How to process a request:

Fax: 801-374-2615

Mail: Central Utah Clinic Medical Records
1055 N. 500 W.
Provo, UT 84604

Phone: 801-429-8062

Forms Required for Release:

All Patients must fill out the two following documents for release of records:
(Auth Release Doc) (Pricing Page)

Additional Forms:

For the release of a minor’s records- (Minor Custody Affidavit)

For the release of a deceased person’s records- (Deceased Patient Record Request)