Lone Peak Hospital values your privacy rights and takes many precautions to safeguard your health information. We want the right people to get information necessary for your care, and make your access to information as convenient as possible.

Your medical record contains documentation by all physicians and healthcare providers involved in your care and treatment while you were here at LPH. It contains the results of diagnostic testing and any therapeutic procedures performed, as well as information about your medical history, and your condition and progress during your hospitalization.

How Do I Receive My Medical Record Information?

During your hospital visit, you should have been given the opportunity to enroll in MyChart which is a feature offered with EPIC the electronic medical record system utilized by Lone Peak Hospital. This feature allows you to access your own records via an internet connection. If you would like more information about this feature, please call (801) 715-4184. You may download the enrollment form here and return it to the Information Desk at Lone Peak Hospital.

Federal HIPAA laws require an authorization to be completed for all medical record requests, unless your provider is requesting them for your care. Your medical record, and the information it contains, is confidential. Therefore, we must confirm your identity before releasing your medical record. Only the patient or his/her legal guardian can sign the form. You can download the authorization form below:


Release of Information Form:

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To obtain copies of your medical record, please bring all of the documents listed below with you to the Information Desk in the main lobby at Lone Peak Hospital.

  1. Authorization for Use and Disclosure of PHI Form — Must be fully completed and signed
  2. A current government issued photo ID (passport, driver’s license, Utah ID, or military ID)

Please be aware that it may take 5–7 business days to receive your records.

Our goal is to get your health information to the appropriate healthcare provider as quickly as possible; therefore, we recommend that your physician (or other healthcare provider) request a copy of your medical records to be faxed directly to his/her office by fax or they access them directly within the EPIC system. There is no charge to you for this service.

If you are unable to print the forms from this website, you may pick up a paper copy of the authorization form in person. Please visit the Lone Peak Information Desk in Entrance 1 of the hospital where blank forms and instructions are available. You can fill out the forms and turn it back in at the desk. The Information Desk will forward your request to the Release of Information specialists for processing.

Contact Information

If you have additional questions, you can call the Release of Information specialists at (866) 270-2311. You may also fax your completed forms to the toll-free number (877) 865-9738 or mail to:

Release of Information
ATTN: HealthPort
525 Metroplex Drive
Nashville, TN 37211

Read more about our responsibilities and your rights for privacy here.