To begin the process of obtaining copies of your medical records, please print and complete the form "Authorization for Use or Disclosure of Health Information."click here
In order for the Health Information Management Department (HIM) to process your request, all information requested must be provided. An HIM staff may call you for additional information if necessary.
If you have any questions regarding the process, please call the HIM Department at 626-570-1606, Ext. 3212.
Please fax the completed form(s) to 626-656-6005 or mail to:
Alhambra Hospital Medical Center
Health Information Management Department
100 S. Raymond Avenue
Alhambra, CA 91801
The pertinent part of the medical record is available to patients at no charge. This includes the discharge summary, history & physical, consultations, procedural reports, radiology (diagnostic imaging) and laboratory reports. For copies of additional portions of the medical record, a fee of 25 cents per page will be charged to you. A bill may be mailed prior to the records being copied and sent to you. Money orders will be accepted via mail made out to Alhambra Hospital Medical Center . There is no charge if the copies of the records are sent to physicians for your follow up care or treatment.