医疗记录

We are here to provide you with your medical records, and strive to fulfill your request timely while ensuring your privacy. The following information will help guide you in the options available and provide 常见问题解答s and contact information if you have any questions.

Obtaining Your 医疗记录

Option 1: Request medical records via your myUCLAhealth account

If you have not signed up for myUCLAhealth, go to How to Sign Up for myUCLAhealth 请示.

  1. 登录到 myUCLAhealth门户 
    (Request for medical records can only be accessed via PC, mobile devices are not supported at this time)
  2. Follow instructions using links below:

For assistance with your myUCLAhealth account, call 855-364-7052.

Option 2: Follow this link to complete the medical record authorization form electronically.

  1. Have your photo identification ready and follow the prompts.
  2. Once completed the form will be sent to our HIM team directly.

Option 3: Download and print the authorization for Release of Health 信息 form.

  1. Download and print the authorization form for Release of Health 信息 for Patient or a third-party (i.e. Non-UCLA Provider, 保险 Company, Attorney, etc.).
  2. Complete and sign the form.
    Please Note: electronic signatures are not accepted at this time.
  3. Submit completed form via email, fax, or mail.
    电子邮件: (电子邮件保护)
    传真: 310-983-1468
    邮件:
    皇冠hga025大学洛杉矶分校健康
    Health 信息 Management Services
    孔蒂大街10833号.， chs, bh-902
    Los Angeles, CA 90095

    Please note: Unsigned and/or incomplete requests will not be processed and will be returned to requestor.

Medical Record Copy Fee

皇冠hga025大学洛杉矶分校健康 will invoice you for the production of records, and will invoice you by mail/email. 请参阅我们的 Frequently Asked Questions.

联系信息

营业时间: 8:00 am to 4:30 pm, Monday to Friday
电话: 310-825-6021
传真: 310-983-1468
电子邮件: (电子邮件保护)
邮寄地址:
皇冠hga025大学洛杉矶分校健康
Health 信息 Management Services
孔蒂大街10833号.， chs, bh-902
Los Angeles, CA 90095

统计要求

(For physicians and hospital use only)

If you are a physician or hospital and your request is urgent, please fax your request to 310-206-4831.

If you are requesting additional information such as radiology imaging, 病理学的幻灯片, or billing information, please contact the corresponding department below directly:

Request to Amend your medical record

Option 1: Request to amend or add an addendum to your health record via your myUCLAhealth account.

  1. 登录到 myUCLAhealth门户 and fill out the online form. 
    Request to amend your health record can only be accessed via PC. Mobile devices are not supported at this time)
    For assistance with your myUCLAhealth account, call 855-364-7052.

Option 2: Download and print the amendment form to Request to Amend Protected Health 信息 (PHI)

  1. Download and print the Request to Amend Protected Health 信息 (PHI) form
  2. Complete and sign the form.
    Please note: electronic signatures are not accepted at this time.
  3. Submit completed form via email, fax, or mail.
    电子邮件: (电子邮件保护)
    传真: 310-794-1616
    邮件:
    皇冠hga025大学洛杉矶分校健康
    Health 信息 Management Services
    孔蒂大街10833号nue.CHS bh-921
    Los Angeles, CA 90095

For additional information, visit our Frequently Asked Questions.