When you need a copy of your Medical Records, this form will help you make that request from our Health Information office. You can download a PDF.
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Please mail or fax the completed form to:
DBS Health Information, Attn: Release of Information Staff
3680 NW Samaritan Dr., Corvallis, OR 97330
Phone: 541-768-2368
Fax: 541-753-1966
