To request a full copy of your health records:
- Complete an Authorization to Release Protected Health Information form
- Provide proof of valid picture Identification
There are four options for submitting the completed release form and proof of identification:
- Visiting our Health Records office at Yuma Regional Corporate Center at 399 W 32nd Street
- Mailing the documents to: Yuma Regional Medical Center, Attention: Release of Information, 2400 S Avenue A, Yuma, Arizona, 85364
- Faxing to 928-336-7154, Attn: Release of Information
- Emailing to email@example.com
For personal assistance, please call 928-336-7017.
Make sure to include your name, date of birth, address, telephone number and specific date(s) requested on the consent form to assure locating your records. Please indicate if the records are to be mailed to you or another person of your choice. If the records are for your physician, please provide their full mailing address or fax number.
After receiving your health records, if you feel there is a discrepancy on any of the reports, please fill out a Change in the Medical Record
form. Complete the form and return it to the Health Records Department by faxing to 928-336-7154 or e-mailing it to firstname.lastname@example.org.
Please include your name and telephone number on the form in the event we need to contact you. In the space provided, please state what you are requesting to be changed and what document(s) the error is on. By signing the Change in Medical Record form, you are giving us permission to contact the physician of record in regard to your request. Please allow 3-6 weeks for your request to be completely processed.
If you are in need of personal assistance, please call 928-336-7017
Obtaining a Birth Certificate
Yuma Regional Medical Center does not have access to state birth records. To obtain a certified copy of a birth certificate for a child born in Arizona, contact:
Office of Vital Records
Arizona Department of Health Services
P.O. Box 3887
Phoenix, AZ 85030