Release of Information

If you would like to transfer or request copies of your personal medical record, please follow the instructions below. If you have additional questions, please contact our Support Center toll-free at 1-866-Take-Care (1-866-825-3227).

How do I transfer or request copies of my medical record?
To release medical records you must be 18 years of age or older or the parent or legal guardian of the minor whose medical records you are requesting. Follow these instructions to ensure smooth processing of your request:

1. Download and print the Release of Medical Records form.
2. Complete all sections of the form.
3. Include the completed address of where you would like your records sent.
4. Be as specific as possible about the information that you'd like released (e.g. specific dates of service, specific treatment, immunization records, etc.)
5. Please mail or fax your authorization and copy of your Photo ID to:

Release of Information
Take Care Health Systems
4165 30th Avenue South - Suite 101
Fargo, ND 58104-8419
          -Or-
Fax to: 701-277-0352
Attention: PSC – Medical Records

Frequently Asked Questions
Read below for answers to the most frequently asked questions regarding release of medical records. If you have additional questions, please contact our Support Center toll-free at 1-866-Take-Care (1-866-825-3227).

• Can a patient review and/or receive copies of their own medical record? Under normal circumstances, patients have a reasonable right to access their own medical records. All requests by the patient for copies must be received in writing. To request a copy of your medical records, follow the instructions above.
• How long are medical records kept? An electronic medical record is retained for each patient for ten (10) years following the last date of service.
• Who is authorized to sign for release of medical records? The authorization must be signed by the patient or the parent or legal guardian of the minor whose medical records are being requested.
• Who is authorized to sign for release of medical records if the patient is deceased? If a patient is deceased, the authorization must be signed by the appointed personal representative, if any. Otherwise, the surviving spouse, an adult child, a parent, or responsible next of kin may authorize release of records.
• How long does it take to receive requested information? There is a minimum of 4 business days (Monday – Friday 8am – 4pm CST) required from the time we receive the written request/authorization.
• Can my doctor request my records? Yes, only with a HIPAA compliant release form completed by the patient or physician.