To request a copy of your Medical Record from Providence Medical Center,
print off the below form, and mail or fax that form along with a copy
of your official state ID to 913-596-4461.
If you have questions, feel free to call us at 913-596-4178, Monday through
Friday, 8 a.m. to 4:30 p.m.
Click here to obtain our
Authorization For Release of Information Form.
You may also visit the
Patient Portal. If you have questions regarding the Patient Portal, please call 913-596-7241.