Client Request to Access Protected Health Information

You have the right to inspect, or to obtain a copy of, your protected health information (“PHI”) maintained in the designated record set by Sedgwick County. This request should include name, address, description of records to be copied and phone number if necessary for contact or follow up. Information should include personal identification of the client whose PHI is being requested. Personal identifiers include Social Security number and date of birth. A written request must be completed prior to Sedgwick County providing you the requested information. Multiple departments may have your records. Please submit a separate request to each department from which you are requesting PHI.

Sedgwick County will make every reasonable effort to provide the PHI requested in the format requested by you if it is readily producible in such format. If it is not readily producible in such a format, Sedgwick County will make every reasonable effort to provide access to the PHI in a legible hard copy format, or in such other form, as agreed upon by you and Sedgwick County. Sedgwick County may charge fees to provide copies of records and will apply guidelines and fee schedules established for compliance with the Kansas Open Records Act to this purpose.

Sedgwick County may provide you with a summary of the PHI requested, in lieu of providing access to the PHI, or may provide an explanation of the PHI to which access has been provided, if you agree in advance to accept:

  1. The summary or explanation and
  2. The reasonable fees imposed.

How to put in a request

  1. Click here to download the request form

  2. Please complete the form above along with a photo or scan of your driver’s license or picture ID and return using one of the following methods below and your request will be processed within three business days.