Request for Health Information Form
You must include a copy of your photo ID in order for us to verify your identity. We will not release records without photo ID. You have the option of receiving your records electronically via a CD, email, or paper. Please note that if you choose to have your records sent to your personal email, it will be uinsecure and could possibly be accessed by someone other than yourself.
Good Shepherd Health Care System will not be liable for any breech that may be incurred in this scenario. If you have any questions regarding the release of information process, please call (541) 667-3621.