Ascension Providence Rochester Hospital

  • Hospital/Medical Center
  • Primary Care/Clinic
  • Imaging
  • Laboratory

Medical Records Request

As a patient, you have the right to access your medical records. Here you'll find instructions and a convenient form to help us process your request.

In support of the continuum of care, Ascension Crittenton will send medical records to any medical doctor, at the patient’s request, free of charge.  We encourage and support obtaining a second opinion from another physician if a patient is not comfortable with an initial diagnosis, course of treatment or with the medical information provided by their physician.  It is medical professionals who are most qualified to render such a decision, determine the presence or absence of disease and the most appropriate treatment for the patient at any given point in time. Ascension Crittenton is  fully committed to protecting patients’ privacy and will release records at the request, and with the consent, of the patient to support this continuum of care.

If the request for the medical record is for personal use, or from a lawyer, there is a fee.  The amount will vary based upon the number of pages of the medical record being requested.  Staff will discuss options with the requestor to minimize the costs while still meeting their needs in the most efficient manner.  Payment is not collected or managed by Ascension Crittenton Hospital.

To request your medical records, fill out the Authorization to Disclose Health Information form.

Once completed, you may:

  •  Mail it to: 
    Ascenion Crittenton Hospital
    Medical Records Department
    1101 W University Drive
    Rochester, MI 48307
  • Fax it to: Ascension Crittenton Medical Records (248) 652-5191
  • Drop it off in person to the Medical Records Department. Please call (248) 652-5221 for hours and directions.

Requests for a copy of a Birth Certificate:
Births prior to 1985:
Oakland County Clerk
1200 N. Telegraph
Pontiac, MI 48053

Births after 1985:
City of Rochester Hills
Office of Clerk
1000 Rochester Hills Drive
Rochester Hills, MI 48309