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How can I obtain my medical records? 
1. Download and print the Authorization for Release of Health Information form below
Request by Patient for Access to their Medical Records
Authorization for Release of Information to 3rd Party (Non-UCLA Provider, Insurance Company, Attorney, etc)
- Authorization for Release of Health Information - English
- Autorizacion para la Divulgacion de Informacion Medica - Spanish
2. Complete and sign the form
3. Fax or mail the completed form to the address or fax number below. You may also complete the authorization form in person at our office during business hours.
Please note: Unsigned and/or incomplete requests cannot be processed.
Mailing Address
Send a written authorization request to have your medical records copied or inspected to:
UCLA Health System
Health Information Management Services
10833 Le Conte Ave., CHS - Suite BH-225
Los Angeles, CA 90095
Fax Number
You may also fax your request to (310) 825-3356
Contact Information
Phone Inquiries (310) 825-6021
Business hours: Monday - Friday 8:00 am-4:30 pm
www.uclahealth.org/medicalrecords
Patients seen by providers in private practice will need to contact those offices directly to obtain their medical records.
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