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MEDICAL RECORDS (Health Information Management or HIM)



Our HIM team - also called Medical Records - is committed to protecting and maintaining your health records.

Hours


The HIM Department is open Monday through Friday, 8:00am to 5:00pm
(With the exception of major holidays)

We Are Moving

On April 6, 2017 we will be relocating to our wing on Arizona Avenue!















Obtaining Records


To receive copies of your records you will need to complete an Authorization to Disclose Protected Health Information form and provide a valid photo ID. If you are requesting records for someone other than yourself you will also need to provide supporting documentation, such as Power of Attorney or Legal Guardianship papers.

Authorizacion para Divulgar Informacion de Proteccion de la Salud

You can submit your request in the following ways:
  • In person - simply bring your completed form to the HIM Department
    • we also have forms available if you are unable to print

  • By mail - mail your completed form, copy of your photo ID, and any support documents to:
    • Northern Cochise Community Hospital
      Attn: HIM Dept
      901 W Rex Allen Dr
      Willcox, AZ 85643
  • By fax - fax your completed form, copy of your photo ID, and any support documents to:
    • (520) 384-9212

We can fulfill your request in the following ways: (please specify preference when requesting)
  • In person - remember to bring photo ID
  • By mail - make sure to include your mailing address on your request
  • Electronically - records can be provided on a thumb drive

Charges

  • Records for continuing care/follow up appointments:
    • No charge
  • For any reason other than continuing care:
    • First 6 pages are free, anything over that will be 25¢/page + a $12.50 copy fee

Advance Directives


There are two Notary Public working in our HIM Department who are available to notarize your Advance Directives free of charge. Please bring your unsigned forms as well as a Driver's License or State ID with you. Once your forms are complete we will be happy to put a copy in your chart.

Patient Portal


You can now access many of your patient records by following this link: Patient Portal. In addition to patient records, there are many health related topics you can explore and study, get health tips, or record and consolidate personal data from your own health device.

To join the patient portal you will need to complete a Patient Portal Opt-in Form.

Portal del Paciente Opt-in

Bring your form along with a photo ID to the HIM Department and we will register you in the system; soon after you will receive an email with log-in instructions.

Parents/Guardians can register as a Representative for a minor's patient portal. Fill out an Authorized User Access Request form, and bring it along with a photo ID and any necessary support documents to the HIM Department. You will remain a Representative until the minor reaches the age of 18, at which point they can register their own patient portal.


Non-Patient Requests for Records (Physicians, Healthcare Providers, Insurance, Legal Requests)

  • Fax a request to:
    • (520) 384-9212
  • Mail request to:
    • Northern Cochise Community Hospital
      Attn: HIM Dept
      901 W Rex Allen Dr
      Willcox, AZ 85643

Turnaround time:
  • In most cases we are able to fill requests within 24 hours
  • For large requests we ask that you allow 72 hours for completion
  • If you need records sooner than that please indicate "STAT" on your request

How records are provided:
  • In most cases records will be faxed to you
  • Large requests may need to be mailed
  • You can request that records be mailed to you if you prefer
  • We can provide electronic records on a thumb drive