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Request for Records at Queen’s North Hawai‘i Community Hospital

Request for Records

Visit MyChart to access your online medical record.  

All additional requests for medical information must be made in writing to NHCH Health Information Management (HIM) Department.  Note: The HIM Department does not maintain or release radiology films.

Please download the Authorization for Use and Disclosure of Protected Health Information form, print, and complete as directed. Forms must be signed by the patient, legal representative, or legal guardian.

Mail or fax the completed form to:

Queen’s North Hawai‘i Community Hospital
HIM Dept. (Medical Records Department)
67-1125 Mamalahoa Highway
Kamuela, HI 96743

Fax 808-881-4649

Duplication fees apply and fees must be paid in advance of receiving records.

There is no charge for physicians and other health care facilities for direct patient care if medical records are sent directly to a physician or health care facility and are requested by the physician or health care facility. If a patient requests information be sent to a physician or health care facility at the direction of the health provider, verification will be made before any records are sent.

If you have any questions, please call 808-881-4652 during regular business hours, Monday through Friday, 8 am – 3 pm, excluding Queen’s observed holidays.