Providing assistance to our patients requesting their medical records.
Completing an Authorization From
The Health Insurance Portability and Accountability Act, also known as HIPAA, requires hospitals to obtain an original, complete, and properly executed “Authorization for Use or Disclosure of Protected Health Information” form in order to provide a copy of a patient’s medical record to a patient or anyone she or he designates. Only the patient, parent/legal guardian, or the patient’s legal health care representative can sign the form to release medical records.
The authorization form must be legible and complete. Authorizations that are illegible or incomplete will be returned. Requests for information regarding any of the following items must also be specifically initialed on the form:
- Chemical Dependency
- Mental Health
During COVID-19 please call us and we will mail an Authorization to you or you may pick up a form from the Receptionist in the Front Lobby. You can also access the Authorization form at the links below.
Submitting The Authorization Form
Medical Records Requests are made by appointment only. Once your “Authorization” form is completed, you may submit your request by mail, fax, or in person.
Mail or In Person
East Los Angeles Doctors Hospital
Attn.: Health Information Management Department
4060 Whittier Blvd.
Los Angeles, CA 90023
Records released to a Physician’s Office or a Medical Facility are free of charge.
Birth certificates for individuals born at East Los Angeles Doctors Hospital may be obtained from the Los Angeles County Office of the Clerk Recorder. Visit their web site at LAPublicHealth.org or you may call (213) 288-7812 for more information. East Los Angeles Doctors Hospital does not keep or maintain birth certificates.
Please note that your medical records do not contain any billing information. For questions about your East Los Angeles bill, please call the Central Business Office at (562) 968-5600.
On behalf of East Los Angeles Doctors Hospital, we sincerely appreciate serving you. We deeply value your relationship with East Los Angeles Doctors Hospital and we are committed to providing you with the highest level of service because our customers deserve the very best.