Medical Records
For patients who need to have their medical record sent to us or to another facility, the following process will be followed to ensure compliance with FTHC policies and with federal laws.
Complete a Release of Information Form
Patients must complete the Authorization for Use or Disclosure of Protected Health Information form which authorized us to disclose a copy of your protected health information to someone other than yourself. You will need to complete a similar form if you want the FTHC to receive a copy of your protected health information from an outside office or hospital (these entities should have their own standard release of information forms).
Where to Submit Forms
The FTHC receives requests for release of records via fax, mail, email, or hand-delivery. Requests should be submitted to the Fallon Tribal Health Center’s Medical Record Office at:
By Mail: P.O. Box 1980, Fallon, NV 89407
- In Person: 1001 Rio Vista Drive, Fallon, Nevada
- By Fax: 775-423-1453
- By Email: medrecords@fpst.org (scanned copy of the form)
Requests are processed within five working days of receiving the request, depending on requestor type. For example, routine or continuation of care and/or urgent requests will typically be processed within one business day.