Medical Records Requests

Munson Healthcare hospitals and provider offices keep a complete medical record of each patient's care. We are committed to ensuring the accuracy, integrity, and security of your information.

You have the right to request copies of your medical record at any time. Much of your health record may also be available for you to view on demand through your hospital or provider office patient portal.

To request a printed or digital copy of your medical record, please complete and return the authorization for release of medical information. Fees may apply.

You must authorize the release of medical information in writing if you would like:

The completed form should be returned to the appropriate Munson Healthcare location by mail, fax, or email or in person. Contact information is included on the form.

The Health Information Management office is open Monday - Friday, 8 am to 4 pm. To learn more, call the location where you received care.

To Obtain or View Your Records

To request a copy of your medical record, please download and fill out the Authorization for Release of Information form. Once the form is complete, you can return it to the appropriate Health Information Management (HIM) department via:

Contact information is listed on the form.

To Request Copies of Radiology Images

To obtain copies of radiology images; fill out, sign, and email Form 3161 with a picture of your government issued ID to Munson@VRCnetwork.com. A link to access your images through the Munson imaging sharing portal will be sent to the email address that was used to send in the request. To access just radiology reports, please log into your Patient Portal.

For providers or facilities looking for imaging for continuation of care, please fax a request to 231-935-3204 or find us on Powershare under “Munson Healthcare".

To Authorize Release of Records

To authorize the release of your medical records to a third party or request your own copy, please download and complete this form. Return the completed and signed form to the attention of Health Information Management at the appropriate location. Contact information is listed on the form.

To Obtain Records of a Deceased Patient

Items such as Durable Power of Attorney, or designation as decision-maker in an Advance Directive are no longer valid after the death of the patient.

A deceased patient’s records can be released if appropriate documentation is provided. This will generally include documentation naming the person with legal authority to release the records (for example, a copy of the patient’s will, an affidavit of surviving spouse or court order for appointed personal representative). If the patient did not pass away at a Munson Healthcare facility, a copy of the death certificate may be required to provide proof of death.

If there is no legal representative, authorizations may be accepted in the order of priority from individuals in the following list, with a signed affidavit of heir:

  1. Spouse
  2. Adult son or daughter (with a signed affidavit of heir)
  3. Either parent
  4. Adult brother or sister

Also, records on deceased persons can be sent directly to life insurance companies for purposes of payment of benefits.

To obtain a deceased patient's medical records, return the completed authorization for release of medical Information form and any supporting documentation to the appropriate location. Contact information is listed on the form.

For Birth or Death Certificates

The hospital does not produce these legal documents. To request a copy, call the State of Michigan at 517-335-8656 or visit the state's website.