What are medical records?
“Medical Records” are defined as clinical, medical, or therapeutic documentation relating to a client which is maintained by Evolve Treatment Centers, also known as Protected Health Information (PHI).
What is Evolve’s medical records policy?
Evolve strives to maintain the highest level of client confidentiality and HIPAA standards.
To request medical records, a release of information authorization form (ROI) must be completed and submitted to Evolve’s Medical Record Department. The ROI must be completed in accordance with state and federal regulations.
The following components should be included:
- Client’s full legal name and birthdate
- Contact information for recipient of written records
- Purpose of disclosure
- Client signature
How do I request Medical Records from Evolve?
To request medical records, please complete the following steps:
Download the release of information authorization form (ROI)
Complete the form in accordance with state and federal regulations.
An incomplete form will delay the process.
The more specific the request, the faster the records will be produced. Please check the specific items you want released and be sure to explain the purpose of this record request so we can best assist you.
The minor client’s signature should be included on the release of information form.
Email or Fax the completed form to Evolve’s Medical Records Department.
Fax: (424) 285-8154
After submitting the completed form to Evolve’s Medical Records Department, the request will be processed. It may take up to 10 business days for the records to be sent via fax, encrypted email, or if preferred, through certified mail.
The Medical Records Department will do its best to send out the records as soon as possible. If there are mitigating circumstances, please inform the Medical Records Department so they can do their best to meet those specific needs.
Please be in touch with any questions. Thank you!
Evolve Medical Records Department
Phone: (424) 502-0803
Fax: (424) 285-8154