Request Medical Records

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Patients who have received care at Western Arizona Regional Medical Center may request copies of their medical record/health information by contacting the hospital and requesting an Authorization for Release, Use and Disclosure of Health Records form.

Download the English form
Download the Spanish form

Choose the most convenient method to submit your completed form:
Fax to (928) 763-0223
Email to 0163_ci_roi_bullhead_city@chs.net
Deliver to the WARMC Information Desk, Monday - Friday, 7 a.m. - 8 p.m.