Health Information Management Department

Northwest Hospital & Medical Center is committed to protecting your medical information. For information about your rights and our obligations regarding the use and/or disclosure of your medical information, please see our Notice of Privacy Practices.

The Health Information Management Department, also known as Medical Records, is open Monday through Friday from 8:30 a.m. to 4:30 p.m.

For Northwest Hospital Patients

To obtain a copy of your medical records from Northwest Hospital, for yourself, your provider, another provider or your designee, please download, print and complete the Medical Information Release form. To access the form, click here. Please follow the directions below.

If you are requesting records on behalf of someone else, please consider the following:

  • If the patient is deceased, please contact our office directly for more information on how to request a copy of the individual’s medical records. Please note that a copy of the death certificate will be required to verify that the patient is deceased if he/she did not expire in our facility. The death certificate is also needed to establish next of kin.
  • If the patient is incapacitated, unable to sign for him/herself and there is a personal representative who is legally responsible, that individual will sign on behalf of the patient.
  • If the patient is a minor under 18 years of age, you will need to contact the Health Information Management Department.

To make requests easy, fast and secure, we ask that you please include a copy of your photo ID with all requests. There are three ways you can obtain copies of your medical history:

Mail: Northwest Hospital and Medical Center
Health Information Management Department
1550 N 115th St. MS D129
Seattle, WA 98133

FAX:  Fax the form, including a copy of your photo ID, to 206-368-1920.

You can pick up and submit the Medical Information Release form in person at the Health Information Management Department D129.

If you are unable to download and fax the Authorization to Release Medical Information form, you may write a letter and include the following information:

  • Patient’s name
  • Patient’s date of birth
  • Patient’s social security number (optional)
  • A copy of your photo ID
  • List of requested information (e.g. surgery report, x-ray report, discharge summary, clinic visit notes, history etc.)
  • Purpose for the request (e.g. personal use, for your physician, attorney etc.)
  • Address where the information is to be mailed
  • Contact phone number of legal guardian (and recipient, if different)
  • Dates of visit(s)
  • Legal guardian’s signature
  • Legal guardian’s relationship to patient (i.e. parent, grandparent, self)

Please send the letter to:

Northwest Hospital and Medical Center
Health Information Management Department
1550 N 115th St. MS D129
Seattle, WA 98133

For Healthcare Providers

If you are a physician’s office or hospital and you would like to request records during office hours, please fax a request on your letterhead to 206-368-1920 including the following information:

  • Patient’s name
  • Patients date of birth
  • Date of service you are requesting
  • Why you need the records
  • When you need records by

If you are a physician’s office or hospital and you are requesting records after hours and for immediate patient care please contact us directly at 206-364-0500 and ask the operator to route you to the on-duty nursing supervisor. Please be prepared to provide the following information:

  • Patient’s name
  • Patients date of birth
  • Date of service you are requesting
  • Why you need the records
  • When you need records by