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Release of Information Form

You can request that Innovis Health release medical record information to another party by completing the Release of Information form below.

PDF Icon Download the release of information form

Please complete all the sections on the form in detail, date and sign it before mailing it to:

Innovis Health
Release of Information
3000 32nd Ave S
Fargo, ND 58103

All release forms must be mailed or faxed to the Medical Records department. Our fax number is 701-364-4315. Federal law does now allow requests via email or phone. Requests usually take between 5 to 15 working days for us to provide the information you request. You will receive a call when your records are ready to be picked up at Innovis Health. Any cost associated with this process is regulated by the State of North Dakota.

Questions

If you have questions regarding the release of medical records, please call us at (701) 364-3330 Monday through Friday, 8:00am to 4:30pm. You may also send us an email using our contact form.

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Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information, please review it carefully.

PDF Icon Innovis Health Notice of Privacy Practices

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