Medical Information Release
You may request a copy of your medical records by completing the "Authorization to Release Medical Information" form (download in PDF format below) and faxing it to the HIM Dept at 661–869–6955.
There is a clerical charge of $10, plus 25 cents per page. Your request will be processed in the order it is received, generally five to seven days.
Please specify what portion of the medical record you would like copies of, for example: X-ray, lab or typed report only.
Download the Release of Medical Information form here:
- Authorization Release Medical Information - English (PDF)
- Authorization Release Medical Information - Spanish (PDF)
For questions regarding release of medical information, please call the HIM Dept at 661-869-6120.