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I am a healthcare risk manager (patient safety, malpractice and other liability and insurance) and I have been doing this line of work for 35 years here in Washington state. I have worked in a variety of clinical settings, from individual clinics, to hospitals, to multi-state healthcare systems. All of the 'unusual' medical records requests come to me for review. I have never seen a records request come in under these firearms laws. Given the enhanced confidentiality provisions of mental health records under state (RCW 70.02, etc.) and Federal law, I would likely not release any information until and unless the actual patient signs a specific release of information. There may be some exceptions to this for exigent circumstances. The firearms laws on the release of information do not hold me harmless and indemnify me if the patient decides to make an issue of releasing the information. Having said all this, I am aware that in Washington, the healthcare authority and DSHS do maintain a database, and they are primarily interested in involuntary commitments as a firearms disqualifier and they do check the records of state mental health facilities. I have not yet heard of the State trolling through medical records of the town psychiatrist, for example.