It is the policy of Methodist Family Health to maintain patients’ confidentiality and always protect patients’ information at all times. Due to the sensitivity of psychiatric records, each request for information will be reviewed appropriately and will follow the Health Insurance Portability and Accountability Act (HIPAA), Arkansas, and Federal regulations.
Authorization/Consent for Release of Information may be submitted online or a printed form may be filled out:
To obtain copies of medical records from Methodist Family Health and its subsidiaries, please download, complete, sign and date the Authorization/Consent for Release of Information form. You may then mail, email or fax it to the appropriate Health Information Management department (see contact information).
You may also complete the Online Submission form electronically.
The following elements must be included in an authorization request to be compliant with HIPAA:
In order to complete a request for medical records, an authorization must be signed by the legal guardian along with a valid form of identification. To prove guardianship, you may be requested to provide other pertinent documentation, i.e., copy of driver’s license, divorce decrees, court documents, custodial and non-custodial.
Unsigned, not completed, or undated requests will not be processed.
Arkansas Code 16-46-106 allows the Health Information Management Department to charge requesters for the cost of copying medical records. The charges are as follows:
It is the policy of the Health Information Management department to complete requests in the order in which they are received. All requests are processed in a timely manner; however, certain circumstances may cause delays in processing. Our goal is to complete requests within 7 to 10 days of the receipt. If you have an emergency need, we will try our best to accommodate the needs of our parents/patients, which is our number one goal.
Methodist Behavioral Hospital
1601 Murphy Drive
Maumelle, AR 72113
Phone: 501-803-3388
Fax: 501-325-1387 (Medical Records fax only)
Methodist Counseling Clinic
(Please use the following address for any outpatient or school-based clinics; please identify the location that you are requesting the information from.)
1601 Murphy Drive
Maumelle, AR 72113
Phone: 501-803-3388
Fax: 501-325-1387
Methodist Children’s Home: Little Rock Residential Treatment Center
5821 West Charles Bussey
Little Rock, AR 72204
Phone: 501-661-0720
Fax: 501-325-1387 (Medical Records)
Methodist Children’s Home: Dacus Residential Treatment Center
211 Church Street
Bono, AR 72416
Phone: 870-932-8880
Fax: 870-336-7307
You may also email MedicalRecords@MethodistFamily.org to help get a rapid response. Please include the following information in the email: Name, Contact Phone Number.
8 a.m. to 4 p.m.