Patient Request for Medical Records

REQUESTING MEDICAL RECORDS

A patient, or his/her legal representative, may inspect and/or obtain a copy, or have copies of medical records sent to another facility. To request a copy of your medical records please contact Health Information Management at 510-814-4055 or download the Authorization for Disclosure of Health Information Form. The form must be completed, dated and signed.

We ask that you specify what components of your medical records you wish to obtain. Often, the discharge summary, operative report and history and physical contain relevant information to suit your needs.

Requests must be signed, specifically, if requesting/authorizing the following information:

  • Psychiatric Care
  • AIDS/HIV
  • Alcohol/Drug Abuse

Please note we require three to five working days to process most requests.

Release of Information Fees

  • $15 for the first 30 pages
  • More than 30 pages, $0.25 per page for copying plus postage and handling
  • Payment is required before records are released

* There is no charge for requests faxed or mailed directly to another health care facility or physician for the purpose of continuity of care.

Please deliver, FAX, or mail the completed form to:

Alameda Hospital
Health Information Management Department 
2070 Clinton Avenue
Alameda, Ca  94501
ATTENTION: Release of Information Office

FAX: 510-814-4352
Please be sure to note a daytime phone number where you can be contacted.

CONTACT US

For questions about accessing medical records, call 510-814-4055.