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 charge of $10.00 clerical fee and .25 per page. Your request will be processed in the order it is received, generally 5-7 days.

Please specify what portion of the medical record you would like copies of: xray reports, lab reports, typed reports only, etc.

To request copies of actual radiology films - please contact the Radiology Department.

For questions regarding Release of Information please call the HIM Dept at 661-869-6120.

Download the forms here: English | Spanish

There are two ways to submit a referral form to The Wellness Center.

If you would like to download and print your referral form, you may do so by clicking here. A PDF file will open in a new window, and you can fill it out and save it to your computer. To submit it you can either email your form to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it  or fax your form to 661-323-2213.

If you would prefer to fill out an online form and submit that directly to The Wellness Center, please click here.