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This is a summary only of your:
- Allergies
- Immunizations
- Ongoing health conditions
- Prescriptions
- Test results
- Many (but not all) procedures
If you need to send health information to a new physician, this summary should have what your physician needs.
On this page:
Health summary
A basic summary of your online health record. It meets most needs, including changing your physician or switching to another health plan. Learn more.
You can specify the date range, which medical records, and the party receiving the copy of your medical records. Allow 10-15 business days for the completion of your request. Note that Medical Office records released as part of this request may contain references related to mental health, addiction, and HIV conditions. Order an electronic copy of your detailed medical records.
To order medical records other than self (ex: Child) then follow the below steps.
Options to request these records:
- To electronically complete the authorization to disclose health information (PDF) use Internet Explorer or Adobe Acrobat Reader and complete the form then click the submit button at the bottom of the form.
- Download, complete, and email the authorization to disclose health information (PDF) to KPCOReleaseofInfo@kp.org
- Fax the completed form to 303-404-4750
- Mail the completed form to:
Northfield Support Services
Attn: Release of Information
11000 E. 45th Avenue
Denver, CO 80239-3004
If you have any questions, please call our Release of Information office at 303-404-4700.
Disability
Your physician can fill out your form for short- or long-term disability. Contact your doctor for assistance.
Family and Medical Leave Act (FMLA)
If medically appropriate, a medical certification can be submitted to an employer to determine FMLA eligibility.
Complete and submit this request to your doctor to certify your serious health condition(s). Your doctor will review your information to determine the appropriate timeframe requested for certification and may contact you for further information. Request FMLA Medical Certification
All employers accept the Department of Labor FMLA medical certification form Kaiser will provide. No other forms are required. Refer to your employer or leave administrator for details on your organization’s policies on timing for requesting leave and how to submit your form. Once your request has been submitted with all necessary information, please allow up to 7 business days to process your request.
Please read the directions below then click the link Request FMLA Medical Certification to enter your request.
- Do not submit forms directly to your clinician. Requests submitted through the link below or via phone will be routed for review. The amount of time certified is based on in-depth review of our medical record and may not always reflect your original request.
- The completed form will be emailed to the patient’s KP.org message center.
- If you are requesting caregiver leave, please have the member receiving care make the request in their account. We cannot process caregiver leave sent in the caregiver’s account.
- To direct the form to a third party, use the third-party distribution option when completing your request.
Request FMLA Medical Certification
These definitions will assist you in making your request:
Continuous (blocked) leave: A leave more than three (3) consecutive days for your own serious health condition or to care for a family member with a serious health condition.
Intermittent Leave: Leave taken in separate blocks of time due to a serious health condition, such as flare-ups of a chronic condition. You must provide details about the frequency of flare-ups, e.g., number of episodes per month and duration of episodes. A reduced work schedule also falls under intermittent leave.
Parental leave for baby bonding: Parental leave is an entitlement and does not require medical certification nor is your clinician’s signature required. You only need to provide proof of birth, such as a birth certificate, hospital discharge paperwork, or after-visit summaries.
Modification of an existing leave: If any of the above requests require modification after they have already been approved, please contact your clinical team to have your paperwork updated.
Once your request has been submitted with all necessary information, please allow up to 7 business days to process your request.
Immunization record
Your record of immunizations can be used for school, camp, and other needs.
My requests
Track your requests for Medical Records and FMLA requests.
Your completed FMLA request will be sent to your Message Center. Your requests will be available for 90 days from the date you requested them.
Are you a former Kaiser Permanente member?
If you are a former member and need records or other forms, call our Release of Information office at (303) 404-4700.