Request Medical Records

---

Patients who have received care at AllianceHealth Durant and Madill may request copies of their medical record/health information by contacting the hospital and requesting an “Authorization for Release, Use and Disclosure of Health Records” form.

For AllianceHealth Durant, please contact the Health Information Management department at (580) 931-2045 to ask for the medical record request form.

For AllianceHealth Madill, please contact the hospital at (580) 795-0225 to ask for the medical record request form, or download the form in English or download the form in Spanish.

For records requests, you will need a completed ROI form with a copy of a legal ID attached. You must have a legal ID or we cannot release records.

Pick up is available in person or you can receive by fax. Fax requests can be sent to (580) 920-1714.

The medical records department does not have access to billing records or information. For billing questions and copies of bills please call (580) 931-2093.