We no longer have a physical walk-in location for in person Release of Information assistance. We still accept request forms thru MyChart, mail, fax and email. Please call us at (650) 497-8079 Monday - Friday, 8 a.m - 4 p.m., for more information and discuss options for medical records.
We provide access to clear and complete information so you can make the best possible healthcare decisions. Requesting a copy of your medical records is easy, whether for your personal records, or to be sent to another medical facility.
Lucile Packard Children's Hospital is required, under the State of California's Confidentiality of Medical Information Act, to obtain an original and complete Authorization for Release of Health Information form before providing a copy of a patient's records or allowing inspection to anyone, including the patient or their representative. In certain cases a patient's physician, psychologist or social worker may also be required to approve a request.
Print the Authorization for Release of Health Information form:
Authorization for Release of Health Information in English / Authorization for Release of Health Information Form in Spanish
Be sure to provide the exact dates of treatment for which you are requesting information and indicate the type of records you need.
While you may request the entire medical record, the summaries provided in the Discharge Summary, Operative Report, and History & Physical, lab and x-ray reports contain the most frequently requested information.
If you are not sure what information you need, please call us at (650) 497-8079.
Requests must specifically be initialed for the following information:
All record requests for protected confidential and sensitive services for Adolescent patients, aged 12-17 require a signed consent from the adolescent. Records will be reviewed by the provider prior to their release. Providers have the right to deny release if deemed appropriate. If you would like to request this information please complete section B.1 with dates of service and have patient sign section I, on page 6.
Please submit your completed for to HIMS:
Mail
Health Information Management Services
4700 Bohannon Drive, MC 5900
Menlo Park, CA 94025
Email: HIMS-ROI@stanfordchildrens.org
Fax: (650) 725-8496
As another way to request the release of your medical information, the 21s Century Cures Act requires that Stanford Medicine Children’s Health (SMCH) provides you with a computer-readable Electronic Health Information (EHI) Export upon request. If you’d like to learn more about receiving an EHI Export, please contact SMCH HIMS at 650-497-8079.
EHI Export Authorization English / EHI Export Authorization Spanish
Log onto your account and see what is already available. Records are located under the My Record menu and in your Document Center.
Still need records?
Under My Record menu select Request Medical Records. Complete the electronic form and submit for review and processing. Please allow 14 days for processing. Records will be sent to your account for review and can be downloaded. In certain circumstances certain records cannot be sent to your account and will be mailed. Some requests require additional approval. Please see above for more information.
Stanford Medicine Children’s Health participate in secure electronic health information exchange. Our ability to safely share health information with other members of your care team benefits you in many ways.
You may request to be exempted from sharing your health information via our health information exchange program. Note that request for exemption will not prohibit Stanford Medicine Children’s Health from sharing information with each other for permitted purposes.
Stanford employs information exchange in certain situations. If you have questions about this process, please contact our Health Information Management Services department at (650) 497-9322.
As another way to request the release of your medical information, the 21st Century Cures Act requires that Stanford Medicine Children’s Health (SMCH) provides you with a computer-readable Electronic Health Information (EHI) Export upon request. If you’d like to learn more about receiving an EHI Export, please contact SMCH HIMS at (650) 497-8079.
EHI Export Authorization English / EHI Export Authorization Spanish
n June 2022, the U.S. Supreme Court’s decision to overturn Roe v Wade led to legal restrictions against some reproductive health services in many states across the U.S. Stanford Medicine operates in California, where laws protect and enable comprehensive reproductive services for our patients.
No matter where you live or receive care, you may wish to limit access to information about your personal health. This document outlines actions you can take to protect the privacy of your health information, including your reproductive health information.
For more information, please call the HIMS Release of Information Office at (650) 497-8079.
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