We encourage you to download, print and complete these forms prior to your first appointment:
If you wish to have these forms mailed to you, please contact the appropriate office. If you have not received these forms or do not have them completed, please arrive 15 minutes early for your appointment.
Participating Health Plans
We are contracted with many health plans. Please contact your insurance company to verify you are approved to see one of our providers.
To request a copy of your medical record, print the request form and submit it to:
Harrison HealthPartners Med Records
Harrison Support Services Building
2520 Cherry Avenue
Bremerton, WA 98310-4207
We will respond to your request within 15 days of receipt.
There is no charge to forward records to another provider for continuing care. For other requests, charges are as follows:
For third party requests
Paper copies: $.39 per page for first 200 pages, then $.12 per page
Electronic format: $.36 per page for first 200 pages, then $.12 per page
Maximum charge $400
Plus sales tax & actual postage
Pages 1 – 30: $1.09 per page
Pages 31 and higher: $.82 per page
Searching & handling fee: $24
Plus sales tax & actual postage/shipping
If you have questions about information in your medical record, contact the provider of service.
If you have questions about obtaining copies of your medical record, contact the Medical Records Department at 360-744-6450.
Helpful Health Links