Request form for your medical records
For information or help with your request for your Southwest Medical records, please call 1-702-560-2880. For information or help with your request for your Southwest Medical Home Health records, please call 1-702-383-0887.
We can also help you get prior records from a non-Southwest Medical provider. This helps to provide Southwest Medical with your complete medical history. The contact number for help with these requests is 1-702-220-7669.
1. To get a copy of your Southwest Medical records:
Request for Medical Records (English)
Request for Medical Records (Spanish)
2. To ask for your medical records from another provider:
Request for Medical Records (English)
Request for Medical Records (Spanish)
3. To ask for changes or corrections to your medical records:
4. To get a copy of your Home Health program records:
Request for Southwest Medical Home Health Records
Please allow 7–10 days for us to respond to your request.
You have rights regarding your PHI:
Right to inspect and copy
You have the right to look at and receive a copy of your PHI. The PHI may be used to make decisions about you. A service fee of 60 cents per page may be charged.
Right to amend
If you feel that the PHI we have is not right or not complete, you may ask us to fix it. Your request must be made in writing. Send it to:
Attn: Health Information Management
PO Box 15645
Las Vegas, NV 89114-5645
For home health, send your request to:
Attn: Health Information Management for Home Health
PO Box 15645
Las Vegas, NV 89114-5645
We may deny your request if the information:
- you ask us to fix is not part of your PHI that we maintain
- was not created by us
- is not part of the information that you are permitted to inspect or copy
- is correct and complete
You will be provided a copy of the final decision.
Right to an accounting of disclosures
You have the right to ask for an “accounting of disclosures.” This lists any time we have disclosed your PHI for any purpose other than treatment, payment, health care operations or other purposes under the Federal Privacy Law.
We have 60 days to respond to your written request. We may take an additional 30 days in certain circumstances. In these cases, you will be notified of the delay before the 60 days has passed.
To ask for an accounting of disclosures, make your request in writing to the Health Information Management department at the address above.
Right to request restrictions
You have the right to ask for a restriction or limitation on the PHI we use or disclose about you for treatment, payment or health care operations.
You also have the right to request a limit on the PHI we disclose about you to someone involved in your care or the payment for your care. This could be a family member or friend.
For example, you could ask that we not use or disclose information about a surgery you had.
Southwest Medical is not required to agree to your request, though we will attempt to if possible.
Right to request confidential communications
You have the right to request that our communications with you about your PHI be carried out in a certain way or at a certain location. For example, you may ask that we contact you only at work.
How to reach us
Mailing address:
Attn: Health Information Management
PO Box 15645
Las Vegas, NV 89114-5645
Monday–Friday, 8 a.m.–5 p.m.
Phone: 702-560-2258
Fax: 702-667-4612
Mailing address for Home Health:
Attn: Health Information Management for Home Health
PO Box 15645
Las Vegas, NV 89114-5645
Monday–Friday, 8 a.m.–5 p.m.
Phone: 702-383-0887
Fax: 702-242-7956
Release of Information (Southwest Medical providers)
Phone: 702-560-2258
Fax: 1-678-905-5595
Release of Information (other providers)
Phone: 702-220-7669
Fax: 702-667-4614