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.

Fax: 909-558-2454

Mailing Address:

Loma Linda University Health System
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 either mail it to the address specified on the authorization form, or you may 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

Forms

If you are having difficulty accessing the form, please e-mail medicalrecords@llu.edu and a PDF version of the form will be e-mailed to you in response.

We also have specific forms for Behavioral Medicine Center.

Submit your forms in person

Hospital

Loma Linda University Medical Center & Loma Linda University Children's Hospital
Health Information Management Department (Medical Records)
101 East Redlands Blvd. Suite 1200
San Bernardino, CA 92408
Monday - Thursday: 8 a.m. - 5 p.m.
Friday: 8 a.m. - 2 p.m.

Clinics

Faculty Medical Offices
Health Information Management Department (Medical Records)
11370 Anderson Street, Suite 2000
Loma Linda, CA 92354
Monday - Thursday: 8 a.m. - 5 p.m.
Friday: 8 a.m. - 3:30 p.m.

Professional Plaza
Health Information Management Department (Medical Records)
25455 Barton Road, Suite 210A
Loma Linda, CA 92354
Monday - Thursday: 8 a.m. - 5 p.m.
Friday: 8 a.m. - 3:30 p.m.