Appointments & Information: 701-483-6017
Medical Record Release
If you need to have records released, we are required by law to have you complete a written release, which then allows us to transfer your records. A release is specific to one transfer of information to one location. A separate release must be signed each time you request a record transfer. A separate release must be signed for each family member requesting a transfer of records, unless it is for the same location and is within one year of last request. Each release must be signed by the patient, except in the case of a minor child, or if there is a power of attorney on record for another adult.
Upon a patient's written request, a provider, at a reasonable cost to the patient, shall promptly furnish to the patient:
a. Copies of the patient's health record include, but not limited to, laboratory and radiology reports, prescriptions, and other technical information used in assessing the patient's health condition;
or
b. The pertinent portion of the record relating to a condition specified by the patient.
Great Plains Clinic, P.C. reserves the right to assess a fee for the preparation of patient medical records. The processing and retrieval fee is $1.00 per page for the first ten pages and .25 cents per page there after, per release.
Please allow a minimum of two weeks for the completion of a record transfer request.
