To release records from any North Memorial Health hospital or clinic, access MyChart to complete a Medical Record Request form or submit an Authorization for Release of Information form by either mail, fax, email, or online:

MyChart

1. Sign up for or log in to your MyChart account
2. Once logged in to MyChart, click “Your Menu”
3. Select “Sharing Hub”
4. Choose who you would like to share your health information with
5. Request a formal copy
6. Complete and submit the Medical Record Request form

Authorization Form

To send an Authorization for Release of Information by email, fax, or mail, download the form and send the completed file using the following options.

Email: MedicalRecords@northmemorial.com

Fax: 763-581-4447 or 763-581-1075

Mailing address:
North Memorial Health
ATTN: Health Information Management
3300 Oakdale Ave. N
Robbinsdale, MN 55422

Or, you may complete and submit an Authorization for Release online by follow the link below. Note: Please have a copy of your government or photo ID ready.

Online Authorization Form

Please Note:

• Only the patient or their legal guardian can sign the release.
• Records will only be released to the provider or person designated in the “release information to” space.
• To contact a hospital or clinic directly, visit the clinic location webpage for fax and address information.

If you are not finding what you need in MyChart, Health Information Management can assist you electronically. Our office doors are not open to the public, but we can assist your fax, email or mail by following the directions above.

Questions?

Call 763-581-4390 or 763-581-4467

Available Mon. – Fri., 8 a.m. – 4:30 p.m. (closed on major holidays)

North Memorial Health is affiliated with many independently owned and operated clinics. If you visit one of those locations, please contact their offices directly for instructions on how to release your clinic records. Call 763-581-2273 for call assistance.

1. Download and fill out the authorization form
2. To release business office records from Robbinsdale Hospital or Maple Grove Hospital, fax the form to 763-581-4501 or mail the form to:
   Central Business Office
   3300 Oakdale Ave.
   Robbinsdale, MN 55422

Questions?

Call 763-581-4479 or 866-358-2644

Available Mon. – Fri., 8 a.m. – 4:30 p.m.

Log in or sign up for access to certain health records through MyChart, a free service used to schedule appointments, request prescription refills, review health history and more online, any time.

Imaging exam results can be provided on a CD. If you or your healthcare provider is in need of copies of your imaging exams, simply:

1. Call the Imaging Resource Center at 763-581-9567
2. Indicate which exams are needed
3. Pick up your disc in the Imaging Resource Center

Questions about birth certificates should be directed to the Hennepin County Government Center. Call 612-348-8240 or visit their website.