Medical Records

How to Obtain Your Medical Records

The American Recovery & Reinvestment Act of 2009 combined with a growing number of Federal and State statutes regarding privacy and security of your personal health records has necessitated Benson Hospital to implement strict guidelines when releasing copies of your medical records.

Your medical records may be requested from the Health Information Management department in person, by fax or email with a legible copy of your driver’s license for signature verification. To expedite your request, be sure to include the required driver’s license copy, fill the form out completely and sign and date.

Hours of operation are Monday through Friday 8:00 am to 4:00 pm. HIM will be closed the following days in 2016:

  • Memorial Day – May 30
  • Independence Day – July 4
  • Labor Day –-September 5
  • Thanksgiving – Nov. 24-25
  • Christmas – Dec. 24-25
  • New Years – Dec. 31 – Jan 1, 2017

There may be a charge for the cost of reproduction of medical records billed by Benson Hospital. Listed below are the charges for copying medical records.

Pages 1-15……………………………….$15.00

All subsequent pages……………….$0.25 per page

To obtain your records, you need to complete a Medical Records Release of Health Information Authorization Form, which is also available at Medical Records.

For billing issues, please call (520) 586-7749

Allow five (5) working days to pass before requesting status. If you request your records copies to be mailed, they will be mailed to the address provided in the Release Information To section of the form.

Allow thirty (30) days from date of request for processing.

A top priority at Benson Hospital is to protect the security and privacy of patient information. All information contained within the patient medical records is considered confidential and is federally protected under the Health Insurance Portability and Accountability Act (HIPAA). Medical records shall NOT be released without the written authorization of the patient, their legal representative, a subpoena or court order.


To request your records by fax:
(520) 720-6521

To request your records by email:


To request your records by mail:
Benson Hospital
HIM Department
PO Box 2290
Benson, AZ 85602


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