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Information for Submitting Requests

This website allows third parties (e.g. attorneys, other non-patient requestors) to request copies of medical records. Subpoenas, certifications, or special handling requests CANNOT be entered through this portal. Please read the important notes below before continuing to use this system:

  1. This system is designed for third parties to request records. If you are a patient or patient guardian/conservator, please click here to view other options for submitting requests.
  2. In order to protect patient privacy and comply with federal and state regulations, you must submit a copy (scan/photo) of the following information. Failure to upload all required documents through this system within 7 days after beginning the process will result in your request being canceled or delayed.
    1. An authorization form signed by the patient or personal representative authorizing the release of records to you, and
    2. Either
      • The patient's driver's license or other government-issued ID, or
      • The patient's personal representative's driver's license or other government-issued ID, along with supporting documentation establishing the personal representative's authority. Click here for examples.
  3. Information requested through this system must exactly match hospital records. Typographic errors, such as patient name misspelling or incorrect dates of service, may result in your request being canceled or delayed.
  4. A fee will be charged, with the amount determined by the size and type of request. Please read the following options for finding out pricing and follow the instructions that applies to you.
    • All requests:  (562) 698-0811 x13685
    • Additional instructions for attorneys:   Print and complete this form, sign it, and upload it along with other supporting documentation.
  5. If you request records from multiple facilities, you will get ONE tracking number for each facility, as each facility processes records separately. You will receive separate notifications and records from each facility.

If you are unable to complete the above, please refer to this page to review other options for submitting your request.

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Acceptable forms of supporting documentation are listed below. However, the facility where the records you are requesting are located may have additional or other requirements.

Note: Please understand until we have the opportunity to review the request against the medical records, we do not know if additional documentation will be required. You will be notified if we need further documentation.

There has been an error processing your request. Technical support has been alerted, however additional information will help solve this issue. Please send some brief comments describing what you were doing:

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