PATIENT RECORD REQUEST – Effective 12/1/2022

Requesting Your Medical Records

Barstow Community Hospital has partnered with Sharecare for Release of Information (ROI) services. Medical records are legal documents and must be maintained by Barstow Community Hospital. However, release of those records will be completed by Sharecare.

Completion of Authorization Form

To receive copies of your medical records you will need to fill out the required authorization form.
Fill out each section completely, if these sections are not filled out completely, it could delay the release of
records. Please return the enclosed form along with a copy of your Driver’s license in one of the following ways:

Fees for Medical Records

There are fees associated with the ROI process that are governed by state and federal guidelines and Sharecare
adheres to these guidelines. Once records have been copied you will receive an invoice from Sharecare. Although we cannot provide an exact amount, as rates are based on time and material, here are some examples of cost based on the information requested and media preference:

To minimize this fee, we encourage you to limit your request to just the records that you truly
need. If a patient request is less than 10 pages, there will be no cost.

Payment Options