Release of Information

Overview

Download and print the authorization form OR submit the form electronically.

Once the authorization has been verified, the Release of Information Department will fulfill your request within two business days. Requests for images on CD or records being retrieved on paper chart may take longer.

If fees apply, Medicopy will send you an invoice. Once payment has been received, records will be sent by the chosen delivery method.

If records are being transferred directly to another doctor, the service is complimentary and no futher action is needed. 

FEE SCHEDULE
There may be fees for the release of records as permitted by state law (ORS 192.563). 
 
Pages 1-10: Complimentary*
Pages 11-50: Processing fee of $30 + $.50 per page*  
Pages 51+: $.25 per page*  
For copies of images on CD: $20
 
* Postage fees apply if mailed. No fee will be charged to release your records to another physician’s office. A completed authorization may be required *  

 Access the Digital Release of Information Form
 Download the Printable Release of Information Form
 Download the Release of Information Patient Brochure
 Download the Release of Information Office Flyer
 Download the Release of Information Authorization Flyer

FAQ

We will provide your authorization form to MediCopy who will prepare your records for release.  MediCopy will email you a link to retrieve your records online. MediCopy will contact you directly if they have questions about your request.
 

All records released must go through The Oregon Clinic Release of Information Department at 847 NE 19th Ave, Suite 252, Portland, OR 97232. Clinic staff may assist patients with the process, but cannot release records directly (in order to comply with HIPAA).

There may be a fee for the release of records as permitted by state law (ORS 192.563). 
 
Records releases of more than 10 pages are subject to a fee as follows:
 
Pages 1-10: Complimentary*
Pages 11-50: Processing fee of $30 + $.50 per page*  
Pages 51+:  $.25 per page*  
For copies of images on CD: $20
 
* Postage fees apply if mailed. No fee will be charged to release your records to another physician’s office. A completed authorization may be required *  
You may call (503) 935-8383 to speak with a release of information specialist or you may go to our Release of Information office located at 847 NE 19th Ave, Suite 252, Portland, OR 97232.
 

MediCopy is a national company that provides this service for many healthcare organizations across the country.  They understand and comply with federal and state laws.  As a business associate of The Oregon Clinic, MediCopy is authorized to perform this service for us, including the required documentation. 

The Oregon Clinic has partnered with a release of information company, MediCopy, to provide copies of your records to you. The form you sign will be provided to MediCopy for processing. Once the authorization form has been verified, it will take approximately 48 hours to complete.

HIPAA regulations allow medical care providers to ask patients for a written records request. A written request ensures that all necessary information is listed for the request to be processed. HIPAA requires all medical care providers to provide documentation for every records release, regardless how small.