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Medical Records Policy

How do I request a copy of my health information (includes medical records, billing records, and X-ray films)?

You can request a copy of your health information by completing an authorization for records release form and submitting it to AFMCI.
Who is authorized to sign for release of my health information?
The following people are authorized to sign for release of your health information:

  • The patient (Not the spouse).
  • Power of attorney if the patient is unable to sign (Legal document must be provided).
  • Parent (if the patient is younger than age 18).
  • Parent and minor if the patient is 12 to 17 years of age and receiving psychiatric, alcohol, or drug treatment services.  Similarly, the minor signature is required for records containing sexual, contraception, or sexual disease history, and for pregnancy related records.
  • Legal guardian (Proof of guardianship document must be provided).
  • Representative of the estate for deceased patients (Copy of the death certificate and a copy of the representative of estate documents must be provided).

How much does it cost to obtain a copy of my health information?

To reduce unnecessary time and cost, patients should consider requesting specific information rather than a complete record.

  • Patients will be charged a fee for copies of their health information.
  • There is no charge for releasing copies of health information directly to other healthcare providers.
  • The fee for copies of health information is postage plus the following charges.

AFMCI charges the following fees for the copying of health care information.

1-10 pages: $35.00
Subsequent pages: $0.52 per page thereafter.

Additionally, AFMCI charges the actual cost of mailing, shipping or otherwise delivering the provided copies. Copies of x-ray on film will be $15.00 per film. The payment is required before or at the time the records are released.

When will I receive a copy of the medical record?

Copies are processed within 2 weeks from the date the request is received by AFMCI. Recipients will be notified if the request cannot be processed within that time frame.

Who do I contact if I have questions?

If you have any questions, please contact AFMCI at 907 622-4325.


Local, state or federal agencies requesting health care information may be entitled by statute to a different fee. Please inform AFMCI when this situation applies.

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