MEDICAL RECORDS

Medical Records are maintained by the clinic for the time period required by the State of California.

How to request a copy of your medical record:

According to the State of California’s Confidentiality of Medical Information Act, the clinic must receive a complete and properly executed Authorization before providing a copy of the patient’s records to anyone, including the patient. Authorizations signed by a patient representative must include a copy of the durable power of attorney, guardianship, etc.

Most requests are processed in 5-7 business days, large requests may require additional time. Please note there may also be a fee associated with large requests. If you have any questions regarding the fees, please call 909-596-4879.

-Indicate the dates of treatment/admissions for which you are requesting information
-Indicate the type of records needed, i.e. Lab results, x-rays
-Indicate if Radiology/Imaging CDs are needed and date and type of image: XRAY OR ULTRASOUND.
Please note there may be a fee associated with burning CDs.

Information on how to request a copy of your medical record:

You can complete the Authorization for Use or Disclosure of Health Information by clicking the button below: