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  • Archives for Trinity Health Release of Information

Trinity Health Release of Information

How do I contact Release of Information?

Hours of Operation: Monday thru Friday, 8 a.m. to 5 p.m.
Phone Number: 701-857-5390
After Hours: 701-418-7680
Fax Number: 701-418-7671
E-mail Address: [email protected]
Mailing address

Trinity Health ROI
P.O. Box 5020
Minot, ND 58702

Physical Address
Trinity Hospital

2305 37th SW, Hospital Entrance, Take the main elevator to 5th floor, turn Right. Photo ID required.

Who can sign a Release of Information form?

  • Patient (18+ years of age)
  • Parent (under 18) – a Step-parent cannot sign
  • Legal Guardian – Legal paperwork must be submitted with the Release of Information Form
  • Power of Attorney (if the patient is incapacitated) – Power of Attorney paperwork must be submitted with the Release of Information Form

NOTE: Trinity Health does not accept electronic signatures

How do I complete the Release of Information Form?

  • Fill in your name, address, phone number and date of birth
  • In the Information to be released section, specify what records you are requesting
    • Specify dates of service and what records (e.g. immunization record, knee treatment, Cardiology records, etc.)
  • Select your preference in the Method of Release and Method of Delivery sections
  • If Mental Health or Chemical Dependency records are being requested, complete the box in the middle of the page. Be sure to sign and add the date and time.
  • In the Release To section, enter the information for who/where the records are to be released to. The following parts are required
    • Name/Facility
    • Address
    • City/State
    • Phone
    • Fax (if you selected fax as the method of release)
    • E-mail (if you selected e-mail as the method of release)
    • Sign the bottom and add the date and time

How do I transfer or request copies of my medical records?

To obtain your medical records, please submit a completed Release of Information Form. The form can be sent to ROI by mail, fax, e-mail or dropped off in person.
In certain cases, the patient’s physician or psychologist may also be required to approve a request before the healthcare information is released.

How do I transfer or request copies of my medical records?

To obtain your medical records, please submit a completed Release of Information Form. The form can be sent to ROI by mail, fax, e-mail or dropped off in person. In certain cases, the patient’s physician or psychologist may also be required to approve a request before the healthcare information is released.

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