Fill out the following form to authorize Yellowstone Surgery Center to disclose your health information. We will use the following information to validate your patient information and attempt to contact you for confirmation.
Yellowstone Surgery Center will not email protected health information.
For Medical Record Request, please fill out the information below. A representative from Yellowstone Surgery Center will call you to complete the request since both a Driver's License and Signature will be required before the records can be disclosed. Normal turnaround time for disclosing records is 10-14 business days from record completion date. All fields must be completed.