Request Medical Records

Newton Medical Center’s Health Information Management (HIM) department is available to help patients obtain copies of their medical records. To request printed or electronic copies of your Newton Medical Center medical records, or to simply inspect them, fill out and sign the Release of Information Form. A valid photo ID is required when submitting the form.

The form can be mailed to:                                      The form can be faxed to:
Newton Medical Center                                                    (316) 804-6261
HIM Department
600 Medical Center Drive
Newton, KS 67114

Requests are processed within five to seven business days from receipt. Records may be picked up in-person between the hours of 8 a.m. and 5 p.m. at Newton Medical Center’s HIM office, located in the basement of the Surgery Center. Records can only be released to the patient requesting them or the person specified in section 2 of the release of information form. A valid photo ID is required for pickup. Records may also be mailed to the patient or faxed to a physician.

 

Download the Release of Information Form

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Form Instructions

Section 1: Basic demographic information for the patient whose records are being requested.

Section 2: From whom the records need to be released (most likely Newton Medical Center).

  • Specify who needs to get the records (i.e. self, physician, insurance, spouse, attorney, etc.).

Section 3: Why do you need the records (personal, continued medical care, legal, etc.).

Section 4: What format do you want the records.

  • Date range or specific dates with year that the treatment/services were performed.
  • Type of record requested.

Section 5: Please read, print and then sign/date.

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