Yes, although we strongly encourage using the online submission form for the most efficient processing. Requests submitted by email, fax, or mail may take additional time to process.

You must provide:

• A signed request on official letterhead (for providers and payors),
  
  OR
• A completed and signed HIPAA Authorization Form (for patients and third parties)

If you are a third-party requesting records on someone’s behalf, you must also include Power of Attorney or other legal documentation.

• Online requests are typically processed within 7–10 business days, depending on the completeness and complexity of the request.
• Archival or paper records may take up to 30 days to process. If additional time is required, our Medical Records team will contact you directly.

Fees may apply in accordance with state and federal regulations. You will be notified in advance if any charges apply.

• No fee is charged if records are sent to another physician or healthcare facility for continuity of care.
• No fee is charged for records available directly to you through your Patient Portal.
• For third-party requests or other purposes, a reasonable cost-based fee may apply, as permitted by law.

Records may be requested by:

• The patient
• Legal guardians or healthcare proxies (with appropriate documentation)
• Healthcare providers
• Insurance companies or payors (for payment or operational purposes)
• Authorized third parties (with signed authorization)

Yes. You may request specific portions (e.g., lab results, imaging, visit notes). Please clearly specify this in your request.

Depending on your preference and the nature of the request, records may be delivered via:

• Secure/encrypted email
• Upload to a secure portal
• Paper copy via certified mail (USPS, FedEx, or UPS)

Please indicate your preferred method of delivery on the authorization form.

• For patients under 12 years old, a parent or legal guardian must sign the authorization.
• For patients ages 12–17, the HIPAA Authorization Form must be signed by:
  • A parent or legally appointed guardian
  • The minor (if emancipated—married, a parent, or living independently)
  • For reproductive health services, either the parent/guardian or the minor may sign

Please include your best contact information when submitting the request. Our team will reach out directly if clarification is needed.

To request records for a deceased patient, you must provide:

• A copy of the death certificate
• Letters of administration or a notarized Affidavit of Distributee
• A HIPAA Authorization Form signed by the legal executor or distributee

You can access the Affidavit of Distributee Form [here] (link to form).

The form is available:

• Online via our website
• Within the online submission portal
• At your doctor’s office
• From the Medical Records Department

Records related to behavioral health or substance use treatment are considered sensitive under HIPAA and state law. These requests must be reviewed and approved by the treating physician before they can be released.

Medical records from practices recently acquired by Essen are still available. Please submit your request using the same online form, and our team will route it appropriately.

You can access our Notice of Privacy Practices here. This document provides important information on how your health data is collected, used, and protected in accordance with HIPAA and other applicable laws. We encourage you to review it to better understand your privacy rights and how your information is handled.