Dental Health Services | Records Request

 

How to Request Records

If you would like a copy of your dental record and/or dental x-rays or delegate this right to someone else, please submit a completed “Authorization to Release/Receive Information” form to [email protected].

Please complete the instructions below before submitting your request: 
  • Sign and date your request
  • If the copy of your records is not going directly to you, please include the address or email of the agency or individual that will be receiving your records
  • If submitting your request by email, enter in the subject line of your email “Records Request”
  • If submitting your request in person to a DHHS dental clinic, please submit this request during regular business hours.  
Once we receive your written request, your records will be emailed or available for pick up 30 days from the date of the request. Photo identification must be presented when picking up dental records in person. You can find copies of our authorization form below: