ER Wait Time: 02:18 | If you are having a medical emergency, call 9-1-1.

Medical Authorization Form

To request a copy of your Medical Record from Providence Medical Center, print off the linked form here, and mail or fax that form along with a copy of your official state ID to 913-596-4461.

If you have questions, feel free to call us at 913-596-4162, Monday through Friday, 8 a.m. to 4:30 p.m.

Click here to obtain our Authorization For Release of Information Form.

Featured Services

emergency icon

Emergency Services


Heart and Vascular

girl icon

Maternity Care

neuro icon


behavioural health icon


General Surgery 1

Surgical Services