Request Your Medical Records

Medical Records

Release of Information

A patient, or his/her legal representative, may inspect and/or obtain a copy of their medical records, or have copies of medical records sent to another facility. Washington Health requires a completed and signed Authorization for Use or Disclosure of Health Information form before releasing any documents to anyone, including the patient.

How to Request a copy of your medical records:

• Print and complete the Authorization for Use or Disclosure of Health Information form
• The release form must be completed, dated and signed
• Please be sure to include the date(s) of service requested
• We ask that you specify what components of your medical records you wish to obtain/release. Often, the Discharge Summary, Operative Report and History & Physical contain relevant information to suit your needs.
• If you request your complete medical record, there will be a service fee. There is also a processing time of up to 15 days for a copy of the complete medical record.
• Requests must specify requesting/authorizing the following information:
  • Mental Health Treatment Information
  • HIV Test Results
  • Alcohol/Drug Treatment Information

If you have any questions regarding release of information, please call 510.818.7415

You may deliver your forms via email or by mail. A photo ID is also required, so please be sure to include a color copy of your photo ID with any request.

Please mail to: 
Washington Health 
Attn: Health Information Management Department (HIM) 
2000 Mowry Ave. 
Fremont, CA 94538

Or Email: ROI@Washingtonhealth.com

For telephone support call 510.818.7415, Monday through Friday, 8 a.m. to 4 p.m. (closed on holidays)