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.
Stanford Hospital & Clinics requires a completed and signed Authorization for Release of Health Information form before releasing any documents to anyone, including the patient. In certain cases, a patient's physician, psychologist or social worker may also be required to approve a request.
Stanford employs information exchange in certain situations. If you have questions about this process, please feel free to contact the Health Information Management Services department directly at (650) 723-5721.
To Request a Copy of Your Medical Records
- Print and complete the Authorization for Disclosure of Health Information form
. - For your information a Medical Record Authorization Instruction form is available to assist in completing the authorization.
- 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 specifically signed if requesting/authorizing the following information:
o Psychiatric Care
o AIDS/HIV
o Alcohol/Drug abuse
o Fertility Treatment - If you have any questions regarding release of health information, please call (650) 723-5721.
To submit your request once your form is completed:
Please bring form to:
Medical Records Department
Release of Information Office
430 Broadway, Room C14, MC5200
Redwood City, CA 94063
Hours: Monday - Friday, 8:00am - 5:00pm
Closed on holidays
Mail form to:
Stanford Hospitals & Clinics - ROI
450 Broadway, Mail Code 5200
Redwood City, CA 94063
Fax form to:
(650) 725-9821
Attn: Release of Information
Release of Information Charges
- $0.25 per page for copying plus postage and handling
- If your charges exceed $100, we require payment before the records are released.
- There will be no charge if request is going to another health care facility to maintain continuity of care.
Additional Information
- If an individual other than the patient is picking up the records, then that individual must have an original signed authorization letter from the patient and along with a photo ID.
- Please allow up to 14 calendar days for your request to be processed. If you indicated the option to pick-up, you will be contacted by the Release of Information Office when your records are ready. A photo ID is required.
Billing
- If you have questions regarding your billing statement, please refer to the Financial & Insurance Information section of this web site.
Radiology Images
If you are requesting radiology images, telemetry tapes or photos, you must contact the department that collected the data.- To obtain a copy of these records, please print and complete a separate Authorization for Disclosure of Health Information form
- You can contact:
o The Radiology Film/CD Library by calling (650) 723-6717
o EKG Film Library by calling (650) 723-7407
o The Pathology Slides Library by calling (650) 723-7211