To Request a Copy of Your Medical Records:
Print and complete the Authorization to Release Medical Information form. The form must be completed, dated and signed in order to release your medical records. Forms may be faxed to (619) 798-3696. Once received, your request will be processed within seven business days.
For questions regarding release of health information, please call (619) 515-2300.
Release of Information
A patient, or their legal representative, may inspect and/or obtain a copy of their records, or have copies of records sent to another facility.
Family Health Centers of San Diego requires a completed and signed Release of Medical Information Consent form before releasing any documents to anyone, including the patient. In certain cases, a patient’s physician, psychologist or social worker may also be required to approve a request.
We ask that you specify what components of your medical records you wish to obtain.
Requests must be specifically signed if requesting/authorizing the following information:
- Psychiatric Care
- Substance Use
- Fertility Treatment
To submit your request once your form is completed:
|In Person:||Please drop off your form at your primary care clinic.|
|By Mail:||Family Health Centers of San Diego
Health Information Management Department
823 Gateway Center Way, San Diego, CA 92102
|By Fax:||(619) 798-3696
Attn: Release of Information
|Hours:||Monday-Friday: 8:00 a.m. – 5:30 p.m.
Saturday: 8:30 a.m. – 5:00 p.m.
Closed most holidays
Learn More About:
Release of Information Charges+
For paper copies is $5 for five pages or less.
$5 base fee and 20 cents per page for six pages or more.
For electronic copies (CD) is $15 set fee.
If an individual other than the patient is picking up the records, then that individual must have an original signed authorization form from the patient along with a photo ID.
Please allow seven to 10 calendar days for your request to be processed. If you indicated the option for personal use, you will be contacted by the HIM department when your records are ready.
A photo ID is required.
Health Information Management Services (Medical Records) Mission+
To provide efficient, accurate and legally compliant electronic health records to enable the delivery of quality care and assure patient safety. We strive to be Exceptional in Every Way! The HIM Department insists on the delivery of an accurate, efficient and paperless electronic health record as a trusted partner for internal and external clients.