Medical Records Request
OBTAINING MEDICAL RECORDS
You must complete an Authorization to Disclose form for release of protected health information and forward the original form and a copy of your photo ID to the Health Information Management Department in-person, via fax (702-873-1859), or mail to:
Spring Mountain Treatment Center
7000 Spring Mountain Road
Las Vegas, NV 89117
Spring Mountain Sahara
5460 West Sahara Ave.
Las Vegas, NV 89146
- An original authorization form is required for each release. Do not list multiple parties on the same authorization.
- The specific information to be released must be noted and all sections must be completed on the Authorization to Disclose form in order to process your request.
- The authorization form must be signed by the patient (ages 18 and older) or by the parent or guardian for all minors (17 and younger).
- The legal guardian in cases of adjudicated incompetence must sign the authorization. Proof of guardianship must be provided. When applicable, the request must be accompanied by proof of Durable Power of Attorney. In the case of a deceased patient, a copy of the death certificate and proof of status as administrator of the estate must be provided.
- According to the Nevada Revised Status (629.061), medical records printed or photocopied for reasons other than continuity of care are subject to a copy fee of $.60 per page.
If you have any questions, contact the Health Information Management Department at (702) 873-2400.