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Medical Records

To request a copy of your medical record, complete the release of information (ROI) form appropriate for the location(s) at which you received services.  See instructions under each location tab below.

Cost for Patients to Request Medical Records

The FIRST TWO PAGES are FREE and the remaining pages are billed as follows:

  • Electronically maintained records delivered in electronic format $6.50
  • Electronically maintained medical records combined with paper records delivered in Electronic format are billed at $6.50 (for the electronic portion) + $0.07 per page (for the paper portion) for labor involved in creating an electronic copy of the records maintained on paper
  • Electronically maintained records delivered on paper are $0.90 for labor cost to create the paper copy of the record maintained electronically plus $0.05 per page for paper and toner
  • Paper records delivered in electronic format are $0.07 per page for the labor involved in creating an electronic copy of the records
  • Paper records delivered on paper are $0.12 per page
  • Plus, postage and applicable taxes

Records can be sent directly to your physician for continuing care, please ask us about this option.

Mid Dakota Clinic, a member of PrimeCare, but not a CHI St. Alexius Health owned clinic, maintains their clinic records at the Mid Dakota Clinic. If you need records for clinic care provided at Mid Dakota, please contact the Mid Dakota Clinic Release of Information Nurse.

CHI St. Alexius Health gives you, or your authorized representatives, three options for accessing your health information:

  • View portions of your medical information via MyChart.
  • Use another application to access your health information.
    • Currently available is the Health app, which is offered by Apple Inc. for iPhones with iOS version software 11.3 or greater. You will recognize it easily by the heart image. The Health app consolidates all of your health data from iPhone, Apple Watch, and third-party apps you already use, so you can view all your progress in one convenient place. This includes your health records from CHI St. Alexius Health and other health systems if you choose to add to add them. To get started:
      • You will need to first set up a portal account with MyChart.
      • The username and password you choose will be the security component for your health information and make it possible for you to access and import it.
      • Please note: Catholic Health Initiatives reserves the right to disable a third-party application, if needed. That application’s terms of use will apply and CHI will not have the control or ability to secure the data you place within that system.
  • Authorized for Release of Information Form
  • Patient Request for Own Release of Information Form

Complete the form in its entirety. Be sure to include all entities of CHI St. Alexius Health where records are needed and sign and date the form.

Return form to the appropriate location(s) in person or by fax, mail, or email where indicated. If you are emailing the form, you must scan the completed document and attach it to your email. The above form is not interactive.

CHI St. Alexius Health Bismarck Medical Record Department

To obtain records from:

  • CHI St. Alexius Health Bismarck Medical Center
  • Heart & Lung Clinic
  • CHI St. Alexius Health Clinics
  • Archway Mental Health Services

Fax the completed form to (701) 530-8984 or call (701) 530-8935 for questions. You may also mail the completed form to:

CHI St. Alexius Health Bismarck
Health Information Management Department
Post Office Box 5510
Bismarck, North Dakota 58506-5510

In Person: The Medical Record Department located on the first floor of the medical center in the administrative hallway.

CHI St. Alexius Health Urgent Care on Main

For records, fax the completed form to (701) 530-3801 or call (701) 530-3800 for questions. You may also mail the completed form to:

CHI St. Alexius Health Urgent Care on Main
807 E Main Ave. Suite A
Bismarck, ND 58503

CHI St. Alexius Health Urgent Care on 43rd

For records, fax the completed form to (701) 530-3501 or call (701) 530-3500 for questions. You may also mail the completed form to:

CHI St. Alexius Health Urgent on 43rd
4315 Ottawa Street
Bismarck, ND 58503

CHI St. Alexius Health Urgent Care Pinehurst

For records, fax the completed form to (701) 530-3601 or call (701) 530-3600 for questions. You may also mail the completed form to:

CHI St. Alexius Health Urgent Care Pinehurst
921 W Interstate Ave
Bismarck, ND 58503

CHI St. Alexius Health University of Mary Clinic

For records, fax the completed form to (701) 355-3796 or call (701) 355-3770 for questions. You may also mail the completed form to:

CHI St. Alexius Health University of Mary Clinic
7500 University Dr
Bismarck, ND 58504

CHI St. Alexius Health Mandan Medical Plaza & Urgent Care Mandan

For records, fax the completed form to (701) 530-3780 or call (701) 667-4600 for questions. You may also mail the completed form to:

CHI St. Alexius Health Mandan Medical Plaza
2500 Sunset Dr. NW
Mandan, ND 58554

CHI St. Alexius Health Minot Medical Plaza

For records, fax the completed form to (701) 857-8056 or call (701) 858-1800 for questions. You may also mail the completed form to:

CHI St. Alexius Health Medical Plaza - Minot
2111 Landmark Circle
Minot, North Dakota 58703

For another's protected health information - Use this Release of Information Form

For your own protected health information - Use this Patient Access Request Form

For records, fax the completed form to (701) 652-3030 or call (701) 652-7185 for questions. You may also mail the completed form to:

Release of Information
Carrington Health Center
PO Box 461
Carrington ND 58421

There may be a charge for copies of your medical records. Upon payment for the copies your request will be processed. 

For another's protected health information - Use this Release of Information Form

For your own protected health information - Use this Patient Access Request Form

For records, fax the completed form to (701) 662-9653 or call (701) 662-9785 for questions. You may also mail the completed form to:

CHI St. Alexius Health Devils Lake
Attn: Health Information Management
1031 7th St. NE
Devils Lake, ND 58301

In person: Requests will be handled at the Admissions desk located at the Main Entrance.

Office Hours: M-F from 8:00 am to 4:30 pm

For another's protected health information - Use this Release of Information Form

For your own protected health information - Use this Patient Access Request Form

For records, fax the completed form to (701) 456-3822 or call (701) 456-4268 for questions. You may also mail the completed form to:

CHI St. Alexius Health Dickinson
Attn: Health Information Management
2500 Fairway Street
Dickinson, ND 58601

In person: Enter the hospital's main (south) doors.  Follow the corridor to the right, then take your first left.  Medical Records (Health Information Management) is in that hallway.

Office Hours: M-F from 8:00 am to 4:30 pm 

Fee Information

CHI St. Alexius Health gives you, or your authorized representatives, three options for accessing your health information:

  • View portions of your medical information via MyChart.
  • Use another application to access your health information.
    • Currently available is the Health app, which is offered by Apple Inc. for iPhones with iOS version software 11.3 or greater. You will recognize it easily by the heart image. The Health app consolidates all of your health data from iPhone, Apple Watch, and third-party apps you already use, so you can view all your progress in one convenient place. This includes your health records from CHI St. Alexius Health and other health systems if you choose to add to add them. To get started:
      • You will need to first set up a portal account with MyChart.
      • The username and password you choose will be the security component for your health information and make it possible for you to access and import it.
      • Please note: Catholic Health Initiatives reserves the right to disable a third-party application, if needed. That application’s terms of use will apply and CHI will not have the control or ability to secure the data you place within that system.
  • Authorized for Release of Information Form
  • Patient Request for Own Release of Information Form

For records, fax the completed form to (701) 530-8984 or call (701) 530-8935 for questions. You may also mail the completed form to:

CHI St. Alexius Health Bismarck
Health Information Management Department
Post Office Box 5510
Bismarck, North Dakota 58506-5510

For another's protected health information - Use this Release of Information Form

For your own protected health information - Use this Patient Access Request Form

For records, fax the completed form to (701) 774-7468 or call (701) 774-7048 for questions.

You may also mail the completed form to:

CHI St. Alexius Health
Attn: Medical Records
1301 15th Avenue West
Williston, ND 58801