Medical Records Request

Health Records Request

To request the health record of a currently incarcerated individual, previously incarcerated individual or a current parolee, a valid authorization form must be submitted to doc_healthrecordrelease@state.co.us or fax: 719-960-3504. 

Authorization forms can be found HERE.

A valid authorization form must contain the following (per the Code of Federal Regulations § 2.31):

1. The name of the patient.

2. The specific name, entity, or individual permitted to make the disclosure.

3. Specific dates of information to be disclosed.

4. The name of the individual or entity which a disclosure is to be made.

5. Special instructions for entities that facilitate the exchange of health information and research institutions.

6. The disclosure must be limited to that information which is necessary to carry out the stated purpose.

7. A statement that the consent is subject to revocation at any time.

8. The date, event, or condition upon which the consent will expire if not revoked before. 

9. The date on which the consent is signed.

If you are a medical office or health agency requesting health and/or behavioral health records the following will need to be provided:

• A valid authorization form that specifies what records are being requested.

• A copy of a HIPAA compliance form stating that your patient/client was informed of the privacy rights. 

If you are requesting your own health and/or behavioral health records or a designated representative is requesting on your behalf, the following will need to be provided: 

• A valid authorization form that specifies what records are being requesting.

• A copy of your current, valid photo ID.

Any other agencies or entities requesting health and/or behavioral health records the following will need to be provided:

• A letter requesting the health and/or behavioral health record(s) on the agency's letterhead.

• A valid authorization form that specifies what records are being requested.

• A copy of a HIPAA compliance form stating that your patient/client was informed of the privacy rights.

If you are requesting health and/or behavioral health records for a deceased offender:

 Follow the guidelines set forth in Administrative Regulation 950-02: Health Records/Confidentiality/Access

Applicable Fees:

Fees for health records are based upon the rates proved by CRS 25-1-801 and CRF 164.524. Payment must be received prior to the release of the requested health records. Payments can be made in the form of check, money order, or cashier’s check, payable to the Colorado Department of Corrections. Cash or credit cards are not accepted.