HealthInfoNet keeps track of which caregivers have looked at your record, including when they looked at it and what parts they looked at. To receive a list of this information (“an audit report”), please complete the form and follow the instructions below.

Receiving your Record Audit Report

Click here to download an electronic copy of the Record Audit Request Form. To protect your privacy we need to know who you are (“verify your identify”) before we can give you the audit report. To receive your audit report you will need to do one of the following:

  1. Fill out and sign the Record Audit Request Form in front of a notary public, have the notary public notarize your signature, and mail to HealthInfoNet at the address listed on the form.


  1. Call HealthInfoNet at the phone number listed on the form to schedule a time to come to our office in person to fill out the form. You must bring with you a government-issued picture ID such as a driver’s license or passport. This option does not require a notary signature.

Once we have received your completed form and verified your identity, your audit report will be mailed to the address you provide on the form within two business days.