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