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  • Records, Forms and Certifications | Kaiser Permanente
    Request your medical records, forms, and certifications, with personalized assistance available based on your region
  • Custom Care Coverage Just For You | Kaiser Permanente
    Important notices Important health coverage tax documents: Learn how Kaiser Permanente provides form 1095-B for proof of minimum essential coverage Learn more You can access your electronic health care and coverage information with non-Kaiser Permanente (third party) web and mobile applications Important notice about a privacy matter Learn more
  • Request Medical Information | Kaiser Permanente
    Visit the My Record section under the Menu in MyChart for immediately downloadable health information to view and print you or your family members’ most commonly requested medical records and reports including: Health summary: Medications, Allergies, Immunizations, Preventative care, and Current health issues
  • AUTHORIZATION FOR USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION
    Kaiser Permanente may not condition treatment, payment, enrollment, or eligibility for benefits on whether you sign this authorization This disclosure is made at your request For Virginia patients, a copy of this authorization, and a note stating to whom your information was disclosed will be included in your medical record
  • Forms publications | Kaiser Permanente
    Under Washington laws you have the right to submit a Request for Confidential Communications asking Kaiser Permanente to send any communications containing your personal health information to you alone, and not to the insurance subscriber that pays for your health insurance For example, you can request that explanation of benefits (EOB), notices of adverse benefit determinations, and other
  • AUTHORIZATION FOR USE OR DISCLOSURE OF PATIENT HEALTH INFORMATION
    Mental Health Treatment Records Addiction Medicine Treatment Records HIV Lab Test Results Kaiser Permanente Oregon locations need to also check this box if they want Genetic Testing information released
  • Authorization For Use Or Disclosure Of Patient Health Information . . .
    Generally, Kaiser Foundation Health Plan of Washington and any other entity covered by the Health Insurance Portability and Accountability Act of 1996, may not condition treatment, payment, enrollment, or eligibility for benefits on whether I sign this authorization
  • Authorization for use or disclosure of patient health information
    number and email Print name of patient, birth date, medical record number (if known), address, phone RECIPIENT INFORMATION: Print name, address, phone number, fax number and email address Delivery method: Please PRINT the email address clearly KP ORG WA – records remain available for 90 days after they are released to your secure member
  • About Health Information Exchange - Kaiser Permanente
    If your non-Kaiser Permanente provider has an electronic record, ask if exchange is possible It’s important for you to tell your health care provider if you have medical records in another Kaiser Permanente region or outside facility Once this is known, your record can be requested (dependent upon exchange capabilities with the outside
  • Health record access update - Kaiser Permanente
    According to the 21st Century Cures Act , Kaiser Permanente is required to provide electronic access to all of your electronic health record at no cost This allows you to see any encounters from your Kaiser Permanente care team that occur to maintain your health record This may include a physician order for a preventive screening, lab test, immunization, or other health-related items





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