Medical Record Requests
Dignity Health – St. Rose Dominican’s Health Information Management (HIM) Department maintains all patient medical records. The medical record is a permanent document of the history and progress of every patient’s medical care and is a compilation of observations and findings recorded by the patient’s physician and members of the hospital healthcare staff.
Patients have the right to receive a copy of their medical records or inspect them, but requests must be made in writing using the forms below.
- The Authorization for the Use or Disclosure of Protected Health Information form is for use when a patient is requesting that their records be sent to someone else (doctor, insurance, attorney, etc.).
- The Patient's Request for Access to Protected Health Information form is for patients or their representative who are requesting records on themselves.
You may print the form, fill it out and return it to the HIM department at the St Rose Dominican hospital you visited. HIM will verify your identity by photo I.D., signature or pertinent questions. We do this to protect the privacy and confidentiality of your records.
HIM has 30 days to respond to your request and make your records available. If you have any questions, please contact HIM at one of the phone numbers listed below.
Dignity Health – St. Rose Dominican, Rose de Lima Campus
ATTN: Health Information Management/Medical Records
102 E. Lake Mead Pkwy.
Henderson, NV 89015
Phone: (702) 616-5300
Fax: (702) 616-4644
Dignity Health – St. Rose Dominican, Siena Campus
ATTN: Health Information Management/Medical Records
3001 St. Rose Pkwy.
Henderson, NV 89052
Phone: (702) 616-5300
Fax: (702) 616-5235
Dignity Health – St. Rose Dominican, San Martin Campus
ATTN: Health Information Management/Medical Records
8280 W. Warm Springs Rd.
Las Vegas, NV 89113
Phone: (702) 616-5300
Fax: (702) 492-8165