Medical Records


This form is used to release patient medical information to the patient, parent, or a third party. To request your patient medical record:

  1. Download and complete the Medical Records Release of Information Form
  2. Print and sign the completed form
  3. Fax the form to (509) 473-6042


 Fee schedule for electronic request of personal health information:

 Item: Price:
 Labor Charge Small (0-100 pages) $9.28
 Labor Charge Large (100+ pages) $18.56
 Encrypted USB Drive $29.69
 Expedition Charge  $10.00 
 Certification Charge  $20.00
 Postage Due (current rate) $1.24  
 Fed Ex Overnight Express  Rate varies upon destination 



St. Luke's Rehabilitation Institute
711 S. Cowley St.
Spokane, WA 99202-1330
509.473.6000

Inpatient Information: (509) 473-6058
Outpatient Information: (509) 473-6869