Request Records

If you wish to request a copy of your medical records, you will need to complete the Authorization for Release of Patient Records form. Once completed, return the form to CapRock either in person or via fax, do not email the completed form or submit it via the website.

Once reviewing your request, we will notify you when your records are available. To keep your information secure, you will need to collect your records in person, or we can send it via fax. You can also authorize us to fax it directly to your physician’s office.   

To access the Authorization for Release of Patient Records form, you may use any of the following three methods:

  • Download it directly using the links below
  • Visit a CapRock location and pick-up a hardcopy
  • Contact us and request the form to be sent to you via email

Fax your completed form

For CapRock Hospital and CapRock 24-Hour Emergency Care:

(979) 314-2360