Patients and Visitors
- Patient Information
- Health Clinic Patient Portal
- Uninsured Patients
- Financial Assistance
- Medical Records
- Health Research
- Visitor Information
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- Mt. San Rafael Hospital Gift Shop
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- Patient and Family Advisory Committee
- Testimonials/Patient Comment Corner
- Medical Aid in Dying
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- No Surprises Act
Medical Records
Number: 719-846-8021Fax Number: 719-846-8025
Requests for information specific to your medical records are processed using the form below. Please follow the link where you can download and/or print the form as needed.
Authorization for Use & Disclosure of PHI
PHI Authorization Forms may be submitted via email to medicalrecords@msrhc.org. For specific questions regarding releasing your records or the records of family members, please contact our Health Information Management department at (719) 846-8021.