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How to Access Your Medical Records at Mosaic
MyChart
By signing up for a MyChart account, you get access to your medical records online or through the MyChart app. Learn more about MyChart here or login to your MyChart account.
Release of Information Form
Release of Information forms are available at our clinics or by request. Call us at 541-383-3005 or visit one of our health centers.
You can return the completed form by:
Fax: 541-383-1883
Mail:
Mosaic Community Health
Medical Records Department
600 SW Columbia Street, Suite 6210
Bend, OR 97702
Request Records for Someone Else
You can gain access to a dependent’s medical record by requesting a MyChart proxy account for an adult or minor. For children 11 and under, a parent/guardian can request proxy access verbally at one of our health centers or over the phone. For youth 12 and over, a proxy access form must be filled out and signed by the parent/guardian. Proxy Access Forms are available at any of our Mosaic locations.
If you are requesting records for another person, please include documentation showing that you are legally allowed to request records on their behalf.
Examples may include:
• Legal guardianship
• Health care power of attorney
• Court order
• Documentation showing you are a patient’s authorized representative
If you have questions about requesting medical records, call or text Mosaic at 541-383-3005. Our team can help direct you to the right department.
Frequently Asked Questions
How long does it take to receive records?
Medical record requests are processed as quickly as possible. Some requests may take longer depending on the type of information requested and whether the form is complete. All requests will be processed within 30 days.
Is there a cost?
Because Mosaic is a Federally Qualified Health Center, there is never a fee for medical record requests.
Can my records be sent to another provider?
Yes. Complete the release of information form and include the provider or organization where you would like your records sent.
Can I request a change to my medical record?
If you believe something in your medical record is incorrect, please contact Mosaic for help with the amendment request process. Amendment requests need to be done in writing via the Amendment request form (available at any of our Mosaic locations) or through Mychart. Providers have 60 days to review and respond to the amendment request.
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