Request your records

You have the right to inspect and receive a copy of the health information Servants Mission Inc. keeps about you in the records we use to make decisions about your care and services (your "designated record set"), including your service records, plans of care, and billing records.

How to request. Submit your request in writing using the form on this page, or contact our Privacy Officer at privacy@servantsmission.net. We verify your identity before releasing any information.

Format. We provide your information in the form and format you request when we can readily produce it that way; if your records are kept electronically, you may ask for an electronic copy. You may also direct us in writing, with your signature, to send a copy to a person or entity you name.

Timing. We act on your request within 30 days. If we need more time, we may take one additional 30-day period and will tell you in writing why and when to expect your information.

Cost. Inspecting your records in person is free. For copies we charge only a reasonable, cost-based fee. See our fee schedule. We never charge for time spent searching for or retrieving your records.

If we cannot grant your request. The grounds for denial are limited, and some denials may be reviewed by a licensed health care professional who was not involved in the original decision. If we deny any part of your request, we explain why in writing and tell you how to seek review where that right applies.

If someone acts for you. A parent, guardian, or personal representative with legal authority has the same right of access, except where we are permitted by law to decline.

Questions: our Privacy Officer, privacy@servantsmission.net.