Mission Hospital - Mission Viejo & Laguna Beach, California
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Medical Records Requests

Health Information Services

Patients, or their legal representative, may inspect, obtain copies of or have copies of their Mission Hospital medical records sent to another medical facility.

Mission Hospital is required under the State of California's Confidentiality of Medical Information Act to obtain an original, complete and properly executed Authorization for Disclosure of Health Information form before the hospital may provide a copy of a patient's 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 Inspect or Request a Copy of Your Medical Records

Print and complete the Authorization for Disclosure of Health Information form

In completing the authorization form:

  • Indicate the dates of treatment for which you are requesting information. This is particularly important for individuals that have had multiple episodes of care at Mission Hospital.
  • Indicate the type of records needed
  • Requests must specifically be initialed if requesting information regarding: AIDS/HIV, Psychiatric Care or Alcohol/Drug Abuse

Information From Your Medical Record

If you are not sure what information you need from your records, please contact us at (949) 365-2230.

Requesting Radiology Images

Radiology Images are not part of your medical record (i.e. your official records contain reports that interpret those images).

Contact the Radiology Film Library at (949) 364-7709 (Mission Viejo) or 949-499-7195 (Laguna Beach) to inspect or request a copy of these records, please print and complete the Authorization for Disclosure of Health Information form.

Submitting a Request

Once the authorization form has been completed the request can be submitted by one of the following methods.

Please bring your medical record request form to:

Mission Viejo Campus
Health Information Services
Medical Office Building #2, Basement
Hours: Monday - Friday, 8 a.m. - 5 p.m., except Holidays

Mail/fax form to:

Mission Hospital
Health Information Services
27700 Medical Center Rd.
Mission Viejo, CA 92691
(949) 365-3889 fax
Attn: Release of Information

Other Important Information About Inspecting or Requesting a Copy of Your Medical Records

You may only inspect records within the Health Information Services Department at the hospital and there may be a retrieval charge. There may be a reproduction charge for creating a copy of your records. Call the Release of Information Office at (949) 364-1400 ext. 4781 for information regarding fee schedules.

  • Mailing Medical Records
    If the medical record is being mailed to you, then you will also be charged for mailing costs.
  • Reproduction Charges
    If the reproduction charges are greater than $100, then pre-payment will be required before your records can be mailed.
  • Sending Records Directly to Another Medical Facility or Office
    All fees will be waived if you are requesting your records be sent directly to another medical facility or office.
  • Processing Time
    Please allow 5 - 10 working days for your request to be processed. You will be contacted by the Release of Information Office when your records are ready for pick-up or mailing.
  • Picking Up Your Requested Medical Records
    If you plan to come to the Release of Information Office to pick up your request, you must bring a photo ID.
  • Someone Else is Picking Up Your Requested Medical Records
    If an individual other than the patient is picking up a request, then that individual will need an original signed authorization letter from the patient and a photo ID.