Download and complete the Authorization to Use or Disclose Healthcare Information form.
Send the completed form via mail, fax or drop off the form in person at any of our clinic locations
P.O. Box 808,
Chewelah, WA 99109
A valid form includes the following:
- Identify the Patient
- Identify the information to be disclosed
- Identify the purpose for which the disclosure is being made
- Contain an expiration date or event that relates to the patient
- Preferred delivery method
- Be signed and dated by the patient or legal guardian
All health record requests are processed within 14 business days from the date the request is received.
NEW Health may charge a fee for copying health records. If this is the case, you will be notified prior to records being copied.
For assistance or questions regarding the status of a request, please contact NEW Health Medical Records Department at 509-935-7542.
NEW Health does not promote the use of non-secure email for sending health records.