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Get a copy of your medical records

Fill out a request form, send it in, and our records team does the rest.

Step 1

Choose the form that fits

Records for you

Use the Request for Access to PHI form to get your own records.

Records for someone else

Use the Authorization to Release Health Information form to send your records to a family member, an attorney, an employer, an insurer or a school. We need your written permission.

Step 2

Send your form in three ways

  1. Fax it to (936) 336-7837, or email it to ROI@libertydaytonrmc.com.
  2. Mail it to LDRMC Release of Information, 1353 N. Travis St., Liberty, TX 77575.
  3. Or bring it to the Outpatient Department on the Travis Street side, with a valid photo ID.
Hours and timing

Know when to come

Monday to Thursday, 7:30 a.m. to 4:30 p.m.
Friday, 7:30 a.m. to 3:30 p.m.
Most requests are done within five business days of a complete form.
Questions? Call (936) 336-7316, ext. 143
Questions

Questions about records

Do I need my photo ID?

Yes. A valid photo ID is required to release records.

Can someone else request records for me?

Yes, with a completed Authorization form. For a medical power of attorney, send a complete copy of it, a government photo ID and a completed Authorization form.

Can I send my records to my new provider?

Yes. Your new provider can call (936) 336-7316, ext. 143 or fax (936) 336-7837, and we will fax the records directly.

How do I check on my request?

Wait one or two days after you send it, then call (936) 336-7316, ext. 143 or email ROI@libertydaytonrmc.com.

Where do I get my child's immunization records?

Immunization records come from the Texas Department of State Health Services website.

Can I see my results online instead?

Yes. Your patient portal shows records online, though results can take up to 72 hours to appear.

Patient Portal

Not sure which form you need? Let us help.

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