Request Medical Records

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Authorization for Release

To send via fax or mail, please download, print and complete the Authorization for Release form:

Via Mail

Ranken Jordan
Attn: HIM
11365 Dorsett Road
Maryland Heights, MO 63043

Via Fax

To: Ranken Jordan
Attn: HIM

Please note that Ranken Jordan HIM can only provide a copy of the information on file. We cannot interpret what the information means or discuss it with you. If you had additional questions about the content of the records, we encourage you to contact your doctor or the treating physician.

Ranken Jordan is committed to your privacy. Read about HIPAA and your privacy.