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Alameda Hospital

Patient Request for Medical Records

Any patient, or his/her legal representative, may obtain or request copies of medical records to be sent to anothre facility or physician

A signed, written request and authorization for release of health information is required before releasing records to anyone, including the patient.  In certain cases, a patient's physician, psychologist or social worker may also be required to approve a request.

How To Request a Copy of Your Medical Records

Please call (510) 814-4037 for the Authorization for Disclosure of Health Information Form.

The form must be completed, dated and signed.

Please specify which components of your medical record you wish to obtain.  Often, the discharge summary, operative report and history and physical contain the most relevant information to suit your needs.

Requests must be signed specifically if requesting/authorizing the following information:

• Psychiatric Care
• AIDS/HIV
• Alcohol/Drug Abuse
  

QUESTIONS?  We are happy to help!

Call (510) 814-4037 or (510) 814-057, then press 2.

HOURS:  Monday - Friday, 8 a.m. - 5 p.m.

To submit your request once your form is completed:

Please deliver, FAX, or mail the form to:

Alameda Hospital

Health Information Management Department

2070 Clinton Avenue

Alameda, Ca  94501

ATTENTION: Release of Information Office

FAX: (510) 814-4352

Please be sure to note a day-time phone number where you can be contacted.