To request copies of your own medical records, or to authorize the disclosure of your medical records to another individual or third party, you will need to complete a HIPAA compliant form and submit your request in writing to the Health Information Services (HIS) department. Note: Please be sure to complete all sections when filling out the form.

Patients, legal guardians and personal representatives with legal authority to make health care decisions on behalf of the individual may obtain medical record copies by one of two methods:

1. Completing a Patient Request for Information form: (English) (Español), or
2. Submitting a request to release the medical record through the Shriners Hospitals for Children Patient Portal. (Note: This process does not require completion of the form listed above.)
   • If you already have access to the Shriners Hospitals for Children Patient Portal, see instructions here.
   • If you do not yet have access to the Shriners Hospitals for Children Patient Portal, contact the Shriners Hospitals for Children registration staff or care manager at this location to request an invitation.

Third parties may obtain medical record copies by submitting an Authorization for Disclosure of Health Information form that is completed and signed by the patient and/or legal guardian: (English) (Español).

Submit the completed forms by email or fax to 509-744-1256.

You may also make a request by sending a completed authorization form to:

Health Information Management
Shriners Hospitals for Children — Spokane
911 W. 5th Avenue
Spokane, WA 99204

If you prefer, you may pick up an authorization form in person by stopping by the health information management office during our regular business hours: Monday–Friday, 8:30 a.m.–4:30 p.m.

Requests for copies take up to 15 business days to process upon receipt of the authorization form. There may be a fee, depending on the size of the request.

Insurance questions

At Shriners Hospitals for Children — Spokane there are no barriers to care. Doctors determine the course of care and all care is provided regardless of the families' ability to pay. The Spokane Shriners Hospital accepts many types of insurance, including Medicaid. If the child is covered by private insurance or a state funding plan, the hospital will bill and accept reimbursement for services provided at our hospital. Any child under 18 with a medical condition that is within the hospital’s scope of services is eligible.

For more information, or if you have additional questions, please call our financial counselor at 509-623-0453.