Your privacy is one of our top priorities. Before ZoomCare can request records from another healthcare provider or release your records to someone else, you may need to fill out a Release of Information Form.
We offer two options for completing this release: online or paper. Choose the method below that best fits your needs.
ONLINE OPTION:
- Click Here if you would like us to send your records to someone else.
- Click Here if you would like us to obtain your prior records from another clinic.
PAPER OPTION:
If you would prefer to fill out our Release of Information form by hand, please complete the following steps.
- Download the form that matches your intended objective.
Here is the form for sending your records to someone else.
Here is the form for having us obtain your prior records from an outside clinic.
- Print the form.
- Complete and sign the form in pen. (Warning: typed signatures will be rejected.)
- Submit your form.
- Click here to submit your form via the message center.
- Email your form to health@zoomcare.com
- Fax your form to 971-256-0049
- Mail it to the address noted at the bottom of the form.
A note about teenage patients: Depending on the state in which you reside, teenagers age 13 to 17 may also be required to sign a release form due to certain privacy laws. If this is the case, the medical records team will contact you with further instructions once your request is received; or you can have the teenager sign the release prior to submission to ensure there are no delays in processing.
