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Requesting Moscow Family Medicine Medical Records

To request copies of medical records FROM Moscow Family Medicine, download and complete the Authorization of Release Protected Health Information. To request copies of medical records be released TO Moscow Family Medicine, download and complete the Authorization to Request Protected Health Information. Failure to provide all requested information may cause a delay in processing your request.

Return the signed authorization form to GMC Moscow Family Medicine by one of the following methods:


GMC Moscow Family Medicine
Attn: Medical Records
623 S. Main St.
Moscow, ID 83843-3046

Our Medical Records department is located at our Downtown Clinic at 623 South Main Street in Moscow. Medical Records representatives are available Monday – Friday, 8 a.m.-5 p.m. We are usually able to process requests within five business days. If you have questions regarding the status of your request or about completing the form, contact the Medical Records Department at 208-882-2011.

Requesting Records on Behalf of a Patient

The following individuals are permitted by law to authorize the disclosure of a patient’s health care information:

  • Parent or legal guardian of a minor (younger than the age of 18)
  • Legal guardian of a patient who has been judged incompetent to manage their personal affairs by a court
  • Attorney or guardian ad litem appointed for the patient by a court
  • Agent of the patient under a medical power of attorney
  • Personal representative or statutory beneficiary of a deceased patient
Moscow Family Medicine
Medical Records department