If you need a copy of your medical records, print and complete the Release of Medical Records Authorization form. Be sure to specify the dates of service and the type of information needed. If you are requesting records sent to you or to a physician outside of St. John Health, you will receive a bill. If you have any questions, please call Providence Hospital and Medical Center at 248-849-5580 or Providence Park at 248-465-4230.
Mail the completed authorization form to:
Providence Hospital and Medical Center
Health Information Management Department
16001 West Nine Mile Rd.
Southfield, MI 48075
Or:
Providence Park
Health Information Management Department
47601 Grand River
Novi, MI 48374
