Patient guide to release of medical records
How to get authorization
To request a copy or have a copy of the medical records sent to another party, call Cook Children’s Release of Information Department at 682-885-1012 between the hours of 8 a.m. and 5 p.m. Monday through Friday. We will mail, fax or email the authorization form. We also have the form available online at https://www.cookchildrens.org/patients-families/medical-records/.
Who must authorize release of information
Parents or legal guardians (without court-imposed restrictions) may obtain and/or authorize the release of protected health information from their child’s Cook Children’s medical record. Individuals 18 or older must authorize the release of their own information.
Written authorization: What to do
- Carefully read the authorization form.
- Provide all requested information.
- Be very specific about the information you need released. Write down dates, types of visits and what parts of the record you need. If you do not know specific dates of service, a date range can be used (e.g. month and year or just year).
- For x-ray images, please check the box on the form that you need x-ray images.
- Sign and date the authorization using your full legal signature.
- Please remember, we will return the form to you if any information is missing or incomplete. This may delay the release of information.
Submission of completed authorization form
Email completed authorization form to releaseofinformation@cookchildrens.org.
682-885-1909 fax
Mail complete authorization form to:
ATTN: HIM Release of Information
Cook Children’s Medical Center
801 Seventh Ave, Fort Worth TX 76104
Identification required
You must provide a valid government-issued picture identification card when picking up records from our office.
Fee for release
Fees and charges may apply for a copy of medical records. This fee must be paid at the time of or before the release is completed.
Time for release
It may take up to 15 business days to process a request. For faster service, we recommend using Cook Children’s MyChart Portal to request and receive medical records electronically.
File a complaint
Contact disciplinary or licensing authority
To contact the disciplinary or licensing authority for Cook Children’s, please call the Texas Health and Human Services Commission at 512-424-6500.
File a consumer complaint
To file a consumer complaint against Cook Children’s, please visit Texas Health and Human Services and/or Texas Attorney General's Office. You can also visit Texas Medical Board which has instructions on how to file a complaint with them directly and Texas Board of Nursing.
If you have any questions, please contact a Release of Information representative at 682-885-1012.