Request your medical records

We walk you through the steps required to request your medical records.

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Patients have a right under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to access their Protected Health Information (PHI) in a Designated Record Set which many people refer to as their “medical record.” Designated Record Sets include documentation of your medical care delivered by Summit and any records used by Summit to make decisions about your care.

There are two options to request your PHI from Summit. In order to better understand which option to use please review the attached chart. The chart reviews whether you need to use a Patient Access Request or an Authorization to Request Medical Records.

Completed forms can be mailed or faxed to the Summit Health Information Services (HIS) Department or dropped off in person at a Summit location. If you would like assistance in determining which form to use or have questions about your records please contact the Summit HIS Department. To reach the Summit HIS Department:

Summit Health Information Services
710 Commerce Drive, Suite 200
Woodbury, MN  55125

Phone: 651-968-5125
Fax:  651-968-5907

Business Hours:  Monday-Friday 8:00am – 4:30pm

How will I receive my medical records and is there a fee?

Your records will be released by the option indicated on the form you complete. Summit does not generally charge a fee to patients to provide copies of health information, but reserves the right to charge a fee in unusual circumstances, such as where multiple requests are made by the patient for the same health information.You will be notified of the fee in advance and Summit will only charge a fee for the cost of copying the health information, supplies for creating the copy and postage if it is mailed.

Amendments to Protected Health Information

Health Insurance Portability and Accountability Act of 1996 (HIPAA) gives individuals the right to have covered entities amend their protected health information when that information is inaccurate or incomplete.

To request an amendment to your protected health information please complete the following form: Request for Amendment to Records

Please send the completed form to:

Summit Health Information Services
710 Commerce Drive, Suite 200
Woodbury, MN 55125


To learn more about medical record releases, contact Health Information Services during business hours at Summit Orthopedics at (651) 968-5125. Health Information Services operates from 8:00 am – 4:30 pm, Monday through Friday.

To review the Summit Notice of Privacy Practices, click here.

To review Summit’s Non-Discrimination Policy, click here.