Requesting Medical Records
A vitally important part of any visit is the medical records that document the course of treatment. Depending upon the length of a patient's treatment of care, this can sometimes add up to hundreds of pages of documents.
Below is a list of Release of Information Requests. Simply complete the appropriate form below online, using the Adobe Acrobat Fill & Sign tool. Once complete, the forms can be emailed to Health Information Services at email@example.com or faxed to 858-673-5187.
- Authorization For Use or Disclosure of Health Info From Palomar Health Medical Group
- Authorization For Use By or Disclosure of Health Information from Palomar Health Medical Group to Self
- Authorization For Use By or Disclosure of Health Information To Palomar Health Medical Group
Due to the large number of requests we process, it may take up to 10 working days to fill your request. You may pick up your copies from the appropriate location listed on the authorization form.
If record copies are to be mailed, please call the appropriate number on the authorization form to make arrangements.
For Questions please call: 858-675-3199
HOURS OF OPERATION:
Monday - Friday: 8:00AM-5:00PM
We are closed on major holidays.
FEES FOR RECORD COPIES
- Records for continuing care may be mailed to a physician at no charge to the patient. (Indicate physician name and address on the authorization form.)
- Medical Information Packets from the most recent visit date are provided free of charge and may include: visit notes, operative report, pathology report, lab results and x-ray reports.
- For other request types, there is a 25/cent per page copying fee. Once your record is retrieved, a Medicolegal Specialist will let you know via telephone how much the total charge will be.
FILLING OUT THE AUTHORIZATION FORM
- Incomplete authorization forms will not be processed.
- The faxing of records is only available to/for physicians.
- The authorization form must be signed and dated by the patient or legal representative.
- If the legal representative is signing the authorization, supporting documentation must be provided (for example: Durable Power of Attorney for Healthcare)
- If the patient is deceased, a Death Certificate, Durable Power of Attorney for Healthcare or will must be provided.