Kaiser Permanente Release of Information

How do I fulfill my request in Oregon & Washington?

Completely fill out and initial all areas of the Authorization for KP to Use/Disclose Protected Health Information (w/Instructions) form and mail, fax or bring in the form to the location nearest you. If there is a cost for the records please also complete the cost letter that pertains to your location: Cost Letter - Protected Health Information. If you have specially protected health information in your chart (HIV, drug and alcohol, mental health or genetic) please make sure you initial in the appropriate area of the form if you would like this information released.