Request Medical Records
To obtain medical records copies, a signed authorization must be submitted to the Health Information Management department from you or an authorized legal representative.
Online Request
You as the patient or legal representative can complete the Authorization for Use or Disclosure of Health Information form electronically using a smart mobile device. If using a laptop or desktop you can complete the form online, then print, scan and upload the authorization. Please note that this functionality is not yet available for PIH Health Good Samaritan Hospital patients.
Start the Request Process
Mail or Fax Request
You can download a paper copy of the Authorization for Use or Disclosure of Health Information form below. Mail or fax the completed authorization to:
PIH Health Whittier Hospital
12401 Washington Blvd.
Whittier, CA 90602
Attn: HIM Department
Fax: 562.967.2908
PIH Health Downey Hospital
11500 Brookshire Ave.
Downey, CA 90241
Attn: HIM Department
Fax: 562.967.2948
PIH Health Good Samaritan Hospital
1225 Wilshire Blvd.
Los Angeles, CA 90017
Attn: HIM Department
Fax: 213.202.7265
PIH Health Physicians
12401 Washington Blvd.
Whittier, CA 90602
Attn: HIM Department
Fax: 562.967.2938
Processing Time
Please allow 3 to 5 business days for your request to be processed.
If your request was submitted electronically, you will be notified via e-mail or text message with status of your request.
If the request was submitted in person or mailed, you will receive a phone call from one of our Release of Information team members.
Contact
If you have any questions regarding how to complete or submit your request, please contact:
PIH Health Whittier Hospital
562.698.0811 Ext. 13685
PIH Health Downey Hospital
562.698.0811 Ext. 26177
PIH Health Good Samaritan Hospital
213.977.2121 Ext. 8127
PIH Health Physicians (Clinics)
562.698.0811 Ext. 13698
Office hours are Monday through Friday from 8 am to 4:30 pm, except Holidays.
