Tri-Med Ambulance is required by law to maintain the privacy of your health information, to provide you with a notice of our legal duties and privacy practices, and to follow the information practices that are described in this Privacy Notice: Notice of Privacy Practices.
To receive a copy of your health information, you may choose to complete the Authorization to Release Healthcare Information Form or write a letter.
If you choose to write a letter, it must include the following required elements:
- Signed by the individual (patient)
- Clearly identify the patient, preferably by name and date of birth
- Identify the preferred method for receiving records
- Identify what records are to be included
Submitting Your Request
Patients may submit their request for records in any of the following ways:
Mail
18821 E Valley Hwy
Kent, WA 98032
Fax
425-454-0208
Online You now have the option of submitting your request and receiving your records online at ChartRequest ( http://app.chartrequest.com/TMA) Creating an account on ChartRequest is free. You can visit the ChartRequest ( https://www.chartrequest.com) website for more information.
Cost
For copies for patients and their representatives, there may be a reasonable, cost-based fee.
To receive a copy of health information for your patient, please make your request in any of the following ways:
Cost
For medical use, there is no fee if records are to be sent directly to a doctor or other healthcare provider for the purpose of continuing care.
Tri-Med Ambulance fulfills third-party record requests electronically via ChartRequest ( http://app.chartrequest.com/TMA). Our company name appears as Tri-Med Ambulance. ChartRequest is a HIPAA-compliant record exchange platform. Creating an account on ChartRequest is free. Please visit the ChartRequest ( https://www.chartrequest.com) website for more information.
Cost
For copies for other uses, the current rates set by Washington State apply.