Requesting Medical Records at Livingston HealthCare

Your Records Are Provided Upon a Signed Request

Livingston HealthCare requires a completed and signed authorization form to release copies of medical records. Please print, complete, date and sign the Authorization to Request PHI form if you need a copy of your record released. All authorizations must be physically signed in order to be processed. A valid photo ID is required in order to process your request. Please include a copy of your ID with any faxed, mailed, or emailed requests.

Return the completed form by either mail, fax, or email:

Livingston HealthCare
ATTN: Medical Records
320 Alpenglow Lane
Livingston, MT 59047

Fax: 406.823.6870


Your request will be processed and mailed within 10 days upon receiving the completed form. For more urgent requests, feel free to contact our Medical Records department at 406.823.6412.