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
- AIDS/HIV
- Substance use
- Fertility treatment
Learn More About:
How to Submit Your Completed Form
+| 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-Saturday: 8:30 a.m. – 5:00 p.m. Closed most holidays |
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.
Additional Information
+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.
Pediatric Patient Portal
+Our online patient portal is now available for individuals under the age of 18. The patient portal is a secure website that allows patients 24-hour access to portions of their medical record. The patient portal allows you to communicate more easily with your medical provider, is available anywhere and free to use.
For more information, click here.
