St. Francis Healthcare System of Hawaii Medical Records
Medical Records Requests and Duplication Fees
All requests for Medical Information must be made in writing to the St. Francis Healthcare System of Hawaii, Medical Records Department. You may download the “Authorization to Release Medical Information” (repeated below) form to print a hard copy and then complete. All requests for Medical Information must be accompanied by this form and signed by the patient, legal guardian or next of kin.
Mail completed and signed authorization form to:
St. Francis Healthcare System of Hawaii
Medical Records Department
PO BOX 29700, Honolulu, Hawaii 96820
If you have any questions, please call The St. Francis Healthcare System of Hawaii Medical Records department, during regular business hours, Monday through Friday, 8:00 am to 4:00 pm at 808-547-8079.
There is no charge for physicians and other health care facilities requesting copies of medical records when being requested for direct patient care if sent directly to the physician or health care facility requesting them. If a patient requests that information be sent to the physician or health care facility at the direction of the health provider, it will first be verified before any records are sent.
All other requests are billed directly to the receiver of the medical records (e.g. attorneys, vocational rehabilitation, etc.). For personal and out-of-state requests, fees must be paid in advance.
Patient Request (Payment required for personal use)
Imaging Film and Electronic Images
CD Copy $20.00 per CD (includes images and reports)
Film Copy $12.00 per film (includes images and reports)
Medical Record Electronic and Paper
CD Copy (PDF format when available):
- $20.00 per CD
Paper Copies Fees
- $.25 per page for hard copies 10 or more pages
- $.50 per page for copies that are on microfilm
Shipping & Handling when applicable (Quote to be provided to requestor)