Medical Records Support
MyChart is the electronic medical record for all St. Luke's patients.
Contact MyChart Support
- Local to Boise Area: (208) 381-9000
- Toll Free: 1-855-890-3402
Hard Copy Medical Records
You are welcome to call our Medical Records/Health Information Management teams for assistance with hard copy medical records.
Contact Medical Records/Health Information Management Support
- Phone: (208) 381-2185
- Fax: (208) 381-1481
- Phone: (208) 587-0330
- Fax: (208) 580-2682
- Magic Valley/Wood River/Jerome
- Phone: (208) 814-0160
- Fax: (208) 814-0909
- Phone: (208) 630-2239
- Fax: (208) 630-2324
- Phone: (208) 706-1115
- Fax: (208) 706-1186
- Phone: (208) 205-7170
- Fax: (208) 205-7171
Medical Record Forms
You must submit a written request to obtain a copy of your St. Luke's medical record. Please use one of the forms below:
- Right to Inspect and Copy Records. Download Form (PDF) English, Spanish (Español)
You may inspect and/or obtain a copy of protected health information that is used to make decisions about your care or payment for your care. We may charge you a reasonable cost-based fee for providing the records. We may deny your request under limited circumstances, e.g., if you seek psychotherapy notes; information prepared for legal proceedings; or if disclosure may result in substantial harm to you or others.
- Right to Authorize a Copy of Records to a Third Party. Download Form (PDF) English, Spanish (Español)
You may authorize a copy of your protected health information be given to a third party. We may charge a reasonable cost based fee for providing the records. The authorization must be signed by the patient or personal representative.
- Right to Revoke. Download Form (PDF) English, Spanish (Español)
You have the right to revoke authorization for use, disclosure, and access to your personal health information (PHI).
- Right to Request Additional Restrictions to uses and disclosures. Download Form (PDF) English
You may request additional restrictions on the use or disclosure of your protected health information for treatment, payment, or health care operations.
- We are required to review the restriction; however, we are not required to agree to a requested restriction except for a request to restrict disclosure of information to your insurance carrier or health plan, if the services that you do not want billed are paid for in full at the time of service.
- If we agree to a restriction, we will comply with the restriction unless an emergency situation or the law prevents us from complying with the restriction, or until the restriction is terminated by you.
- Right to Request Amendment to Record. Download Form (PDF) English
You may request that your protected health information be amended. You must explain the reason for your request in writing. We may deny your request if we did not create the record unless the originator is no longer available; if you do not have a right to access the record; or if we determine that the record is accurate and complete. If we deny your request, you have the right to submit a statement disagreeing with our decision and to have the statement attached to the record.
- Right to an Accounting of Certain Disclosures. Download Form (PDF) English
You may receive an accounting of certain disclosures we have made of your protected health information within the last six years from the date of your request. We are not required to account for disclosures for treatment, payment, or health care operations; to family members or others involved in your health care or payment; for notification purposes; or pursuant to our facility directory or your written authorization. You may receive the first accounting within a 12-month period free of charge. We may charge a reasonable cost-based fee for all subsequent requests during that 12-month period.
- Authorization for Adult Proxy to Access Protected Health Information (PHI). Download Form (PDF) English
This form is to be completed by a patient over the age of eighteen who wishes to grant another adult with proxy
access to their current and future medical records, including billing records, in both written and verbal format.
This form is not valid if altered.
- Delegation of Authority to Make Health Care Decisions.
This form is to be completed by a parent or legal guardian who wishes to authorize another adult to make health care decisions for a child or incapacitated person. This delegation of authority grants a special, limited power of attorney to seek and consent to health care, receive medical information and otherwise make health care decisions for the minor or incapacitated person.