Due to technical difficulties, all Medical Marijuana online applications will be unavailable until 8AM, Tuesday, March 11th. We apologize for the inconvenience and thank you for your patience.
Arizona State Hospital
To request medical records:
To obtain copies of patient's health information (medical records) complete the Authorization to Release Protected Health Information form. Please complete the form in its entirety. Failure to provide all of the requested information may cause a delay in processing your request.
Return the authorization form to Arizona State Hospital:
- Fax - (602) 220-6413
- Mail - Arizona State Hospital
Attn: Medical Records Department
2500 E. Van Buren St
Phoenix, AZ 85008
Please allow 10 to 15 business days (not including weekends) to complete your request. If you have questions regarding the status of your request, or about completing the form, contact the Medical Records Department at (602) 220-6069. Office hours are Monday - Friday, 8 a.m. - 5 p.m. Medical Records is closed on weekends and holidays.
A fee may be associated with the procurement of records. Please contact the Medical Records Department for more information.
Medical records can be obtained for a family member if you are the legal guardian or have power of attorney for that patient. The patient may also request that records be released to a personal representative. Please contact the Medical Records Department for additional information.
To protect patient privacy, records can not be faxed or emailed directly to the patient. The goal of Arizona State Hospital Medical Records Department is to maintain the confidentiality of client health record information, and protect an individual's right to privacy in the collection and disclosure of personal information in accordance to federal, state and Health Insurance Portability and Accountability Act (HIPAA) guidelines.
Note: Files are in PDF format unless otherwise stated.