Medical Records Request

  • Step 1: Please download and complete our Medical Records Request Form.
  • Step 2: Fax your form to the WWMG clinic where the patient was seen. Clinic contact info is below:

WWMG Clinic

If you ARE the patient:

If you ARE NOT the patient:

Family Practice Primary Care:

Everett Family MedicineFax this request form to 425-317-9516Fax this request form to 425-317-9516
Grove Street Family ClinicFax this request form to 360-657-3268Fax this request form to 360-657-3268
Lake Serene ClinicFax this request form to 425-787-1055Fax this request form to 425-787-1055
Marysville Family MedicineFax this request form to 360-659-7267Fax this request form to 360-659-7267
Snohomish Family MedicineFax this request form to 360-568-1722Fax this request form to 360-568-1722
Whitehorse Family MedicineFax this request form to 360-435-3966Fax this request form to 360-435-3966

Specialties:

CardiologyFax this request form to 425-225-2790Fax this request form to 425-225-2790
Earn, Nose & Throat / Allergy / AudiologyFax this request form to 425-791-3094Fax this request form to 425-791-3094
Endocrinology – Everett/ Silver LakeFax this request form to 425-420-1651Fax this request form to 425-420-1651
Endocrinology – MukilteoFax this request form to 425-374-8896Fax this request form to 425-374-8896
Gastroenterology / EndoscopyFax this request form to 425-252-9860Fax this request form to 425-252-9860
Imaging CenterFax this request form to 425-263-8990Fax this request form to 425-263-8990
NephrologyFax this request form to 425-258-1944Fax this request form to 425-258-1944
NeurologyFax this request form to 425-322-0992Fax this request form to 425-322-0992
OrthopedicFax this request form to 425-317-9118Fax this request form to 425-317-9118
PodiatryFax this request form to 425-259-0856Fax this request form to 425-259-0856
PsychologyFax this request form to 425-252-4778Fax this request form to 425-252-4778
Pulmonary – EdmondsFax this request form to 425-673-5466Fax this request form to 425-673-5466
Pulmonary – Everett/ Silver LakeFax this request form to 425-252-1118Fax this request form to 425-252-1118
Rheumatology – BothellFax this request form to 425-248-2627Fax this request form to 425-248-2627
Rheumatology – EverettFax this request form to 425-252-8364Fax this request form to 425-252-8364
Sleep Medicine – EdmondsFax this request form to 425-673-5466Fax this request form to 425-673-5466
Sleep Medicine – Everett/ Silver LakeFax this request form to 425-252-1118Fax this request form to 425-252-1118
Surgery CenterFax this request form to 425-374-5161Fax this request form to 425-374-5161

List of allowed charges for WA State health records. You may also be charged a clerical fee and sales tax for retrieving your records.

Non-patients, please download our Medical Records Release Form and submit per the contact info above. Thank you.