Release of Information
How to start a request for your medical records
Obtaining a copy of your medical record is easy. To start your request, simply download, print, complete, and sign the Authorization for Disclosure of Protected Health Information Form. Fax or mail it back to us, to the attention of the Health Information Management Office.
Loma Linda University Health
Health Information Management Department (Medical Records)
101 East Redlands Blvd. Suite 1200
San Bernardino, CA 92408
Your request will be processed and fulfilled within 15 business days from the day it is received. Please allow reasonable time to process your request. We will mail your records to the address specified on the authorization form. You may also pick them up at our offices. There is a 25 cent per page copying fee.
*Please be sure to sign the form. Unsigned requests cannot be processed and failure to provide all information may invalidate the request.
For additional information or questions, please contact us at 909-651-4191