Request Medical Records (HIM)

 

To request medical records:

A.  Download, Print, and Complete an Authorization Form

For requestors who need to have their medical records from our hospital released to an outside entity:

For requestors who need to obtain medical records from another doctor or facility, and have those records sent to our hospital for treatment of the patient here:

Once you have completely filled out the form, please include a copy of the requestor's valid identification (any government-issued ID such as a passport or driver’s license).

Please note: If patient is over 18 at the time of the request, the patient must authorize release of their medical records and include a valid copy of their identification, including signature (unless they are physically unable to do so).

B.  Submit the Authorization Form

Please submit the Authorization Form along with a copy of identification through one of the following methods:

Via fax:   323-361-1106 or 323-361-1509 Via mail: Children's Hospital Los Angeles

Via e-mail: HIMRequest@chla.usc.edu

Via mail:
Children's Hospital Los Angeles
Attn: Medical Records, Release of Information
4650 Sunset Blvd MS #46
Los Angeles, CA  90027 Follow-up:

To follow up on your request:
Call 323-361-2387 between 8 a.m. - 4:30 p.m.

C. Cost

The cost for requested records is dependent upon the purpose of the request:

  • Personal:  No cost, but please note that any record request that results in over 40 pages (regardless of medium requested) will be put on a CD
  • Outside Medical (released directly to outside physician or outside facility):  No cost
  • Others, including attorneys or copy services: Contact the "Release of Information" Department directly at 323-361-2387 between 8:00 a.m. - 4:30 p.m. for further details

D. Phone Inquiries

For questions or more information, you may call 323-361-2387 during regular business hours. You will be prompted to select English or Spanish as your language of choice, and then be provided with the following options for more information:

  • Press 1 to obtain information about how to obtain copies of a patient's medical record
  • Press 2 to discuss a bill
  • Press 3 to be transferred to the X-ray or Radiology Department
  • Press 4 for other inquiries or to check status of a medical records request
  • If none of the selections above accommodate your needs, you may remain on the phone for a representative to assist you