Requesting Access to Your Health Information

Your health record includes your medical history, health insurance information and how to contact you.

It is the duty of The Urgency Room to ensure that your record remains confidential and is maintained and released in accordance with applicable laws.

How to request access?

You can request your health record information by completing and sending the appropriate paper form.

  1. Complete and send the appropriate paper form to request and send a copy of your health record to:
  2. The completed form can be sent by:
    1. Fax:  952-835-4403 OR
    2. Mail:  The Urgency Room
                ATTN:  Health Information Management/ROI
                4300 MarketPointe Drive, Suite 100
                Bloomington, MN 55435

You can also download the forms here:

Access to Patient Information

Request to Release and Disclose Patient Information


Call: 888-556-5593

Available Monday through Friday from 8AM to 4PM

Send us a secure email:

Contact Us

Include a detailed message with your request. All messages will be responded to via secure messaging. Please check your spam folders.