Patients have the right to view copies of their medical records upon request. Signed request forms must be submitted to the medical records office detailing the specific materials desired. Requests generally take five working days to process and there may be a minimal charge for copying the material.
For More Information
The Medical Records department is located in the Professional Office Building, at:
Monday - Thursday, 8 a.m. - 5 p.m. (Closed for lunch from 12:30-1:30 p.m.)
Friday - 8 a.m. - 2 p.m.
- Authorization for disclosure of PHI from a facility outside the LLUAHSC OHCA to a LLUAHSC entity
- Autorización para la revelación de información médica protegid
- Health information exchange electronic network opt-out consent-Spanish
- Health information exchange electronic network revocation of opt-out-Spanish
- Health information exchange electronic revocation of opt-out
- Health information exchange opt-out consent
- Release of Information Authorization Form: English | Spanish
- Request to Amend Protected Health Information: English | Spanish
If you are having difficulty accessing the form, please e-mail firstname.lastname@example.org and a PDF version of the form will be e-mailed to you in response.