Request Medical Records
Our Health Information Management (HIM) Departments (Medical Records) are open for Release of Information Services Monday - Friday from 9 a..m - 3:30 p.m. (closed for lunch from 1 p.m. - 1:30 p.m.). See general information as well as hospital-specific contact information below.
- How do I request a copy of my hospital medical records?
- Pick up a copy of the Use & Disclosure Authorization Form from the HIM department or one of our screening stations at any of our hospitals and mail, email, or fax the form back to us. The form is also available here for you to review, download, print and complete.
- Please allow 3-5 business days for processing, in addition to mailing time.
- How do I get a copy of my Radiology images?
- You can request your images in the same manner as your medical records. We will be happy to mail an Imaging CD back to you in a secure CD mailer. If you authorize release to your physician and list their clinic address on the authorization form, then we will be happy to mail the CD directly to them.
- If you need your images the same day as your outpatient radiology study, please let the radiology staff know, they will have you complete the Use & Disclosure Authorization form and provide you with a copy of your Images.
- I need assistance with the CareNotify Patient Portal.
- Please call our toll-free support line at 1-855-624-284, Monday through Friday from 8 a.m. to 5 p.m., Eastern Time.
- How do I complete a paternity affidavit or adoption paperwork while you are closed?
- Unfortunately, we will not have notary services during this time.
- You may take the Paternity Affidavit form from your discharge folder to your local bank or library to be notarized and mail the form back to us within 3 days from your discharge from the hospital.
- All birth certificate information must be submitted to Vital Records within 10 business days from your child’s birth date.
- If this is not possible, then when we resume full service, staff will be happy to assist you with a birth certificate correction and a paternity affidavit.
- Adoption paperwork should be taken to your attorney’s office.
Hospital Contact Information
Northwest Medical Center- Bentonville
3000 Medical Center Parkway
Bentonville, AR 72712
Phone: (479) 553-4000
Fax: (479) 271-7018
Northwest Medical Center- Springdale
609 W. Maple Ave.
Springdale, AR 72764
Phone: (479) 757-4500
Fax: (479) 757-2930
Northwest Health- Physicians’ Specialty Hospital
3873 Parkview Drive
Fayetteville, AR 72703
Phone: (479) 684-3056
Fax: (479) 521-5101
Siloam Springs Regional Hospital
603 N. Progress Ave.
Siloam Springs, AR 72761
Phone: (479) 215-3160
Fax: (479) 549-3344
Willow Creek Women’s Hospital
4301 Greathouse Springs
Johnson, AR 72741
Phone: (479) 684-3056
Fax: (479) 684-3107