As a patient of Pagosa Springs Medical Center, you can request access to your medical records. Copies of medical records may be released to other third parties with written authorization of the patient or patient representative. Charges may apply.
To obtain your medical record from Pagosa Springs Medical Center, you can request a copy of your records by completing the form below. You can also view your health information online via the patient portal. Please note: The patient portal does not allow access to a patient’s complete medical record.
You may sign up for free access to your secure health information through our Health-e patient portal. To sign up, email Informatics.Dept@psmedicalcenter.org. You will receive an email with a link to accept your invitation and set up your account. Once you are signed up, you may access your health information through the Health-e link.
For more information on the patient portal, including how to sign up and log in to your account, click here. If you have questions, please contact the Informatics Department at 970-507-3767.
Copies of Your Medical Record
If you are a patient of Pagosa Springs Medical Center (PSMC), you may request access to your medical record by downloading the authorization form below. Please provide the completed form, along with photo identification in person to the Health Information Management (HIM) department, located on the PSMC campus. You can also mail or fax the form with a copy of your photo ID. Copies of medical records may be released to other third parties with written authorization of the patient or patient representative. If you are requesting that we send medical records to another medical provider, please include their name, address, phone number, and fax number to help expedite the information.
Please note: When completing your form, please provide a range of dates or the single date of service being requested, such as visit with my provider on 8/1/2018, or all records related to my knee surgery in May 2018.
- AUTHORIZATION FOR USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION (English)
- AUTORIZACIÓN PARA USO Y DIVULGACIÓN DE INFORMACIÓN MÉDICA PROTEGIDA (Spanish)
Records from other providers may also be sent to PSMC by downloading the form below. Please complete the form and mail/fax to your other provider.
- AUTHORIZATION FOR DISCLOSURE OF PROTECTED HEALTH INFORMATION -OTHER ENTITY (English)
- AUTORIZACIÓN PARA LA DIVULGACIÓN DE INFORMACIÓN MÉDICA PROTEGIDA -OTRA ENTIDAD (Spanish)
Health Information Management (HIM)
Hours: Monday-Friday, 8:00 a.m. to 4:30 p.m.
Pagosa Springs Medical Center
95 S. Pagosa Blvd.
Pagosa Springs, CO 81147