REQUEST INTAKE

Submit a Medical Records Request

Complete your request securely, attach the right documentation, and send it directly into NovaCore processing.

✓Guided IntakeComplete the information needed for your requester type.

▣Secure UploadsAttach authorizations and supporting documents safely.

⌁Easy Follow-UpReceive a tracking number after your request is submitted.

NovaCore Request Center

Submit a new records request, generate an authorization if needed, or track an existing request.

Bulk / Audit Batch

1Submit

2Review

3QA

4Invoice

5Release

Requester Information

Requester TypeRequester / Organization

Patient self-request selected.

The patient will be saved as the requestor automatically. Use the delivery section below to enter the email, fax number, or mailing address where records should be released.

Patient & Facility Information

Facility Name

Patient First NamePatient Last NamePatient Date of Birth

Patient Address OptionalPatient Phone Optional

Date Range / DOS

From Date

To Date

Or Select Preset Range

Records Requested

Select all record types needed. Use additional notes for anything not listed.

All Medical RecordsProgress NotesLabsPathology ReportsImaging ReportsRadiology ImagesBilling / Itemized BillsDischarge SummaryOperative ReportsConsultation ReportsMedication ListDemographicsVaccination RecordsEKG / Cardiology ReportsSleep Study ReportsTherapy / Rehab NotesReferral / OrdersHistory & PhysicalEmergency Department RecordsOther

Additional documents or notes

Delivery / Release Method

Delivery Method

Send a secure download link.

Delivery Email

Secure link delivery uses the delivery email.

The secure download link will be sent to the delivery email entered above.

Authorization / Request Letter

I already have a request letter, authorization, subpoena, court order, audit letter, or supporting document to upload/attach.Upload Request Letter / Authorization / Supporting DocumentAccepted examples: HIPAA authorization, request letter, subpoena, court order, audit letter, insurance request, or provider request.Upload is required when using your own request letter or authorization.

Request can move forward with the requester’s existing supporting document once uploaded.

Additional ID UploadRequired

Please upload the front and back of a valid government-issued photo ID. ID documents are used only for identity verification and request validation.

Front of IDUpload the front side of the ID.Front ID is required.Back of IDUpload the back side of the ID.Back ID is required.

Secure handling notice

ID files are submitted securely and should only be used to verify the requester’s identity.

iBefore you submitHave the patient details, requested date range, and supporting authorization or legal documentation ready when applicable.

1

Enter Request Details

Provide patient, requester, facility, and records information.

2

Add Documentation

Upload or generate the documents required for the request.

3

Review & Submit

Confirm your information before securely sending the request.

✓

Track Progress

Use your NovaCore tracking number to follow the request.

✓Your Information is SecureNovaCore uses secure, controlled workflows to protect request information and records throughout processing and delivery.SECURE REQUEST CENTER