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Health Information Services (Medical Records)
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 initialled if requesting information regarding
- AIDS/HIV
- Psychiatric Care
- 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) 364-1400 x4781.
Requesting Radiology Images
Radiology Images are not part of your medical record (i.e. your official records contain reports that interpret those images).
Requesting Radiology Images
Contact the Radiology Film Library at (949) 364-7709 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 three following methods:
Please bring form to:
Health Information Services
Medical Office Building #2, Lower Level
Hours: Monday - Friday, 8:00am - 5:00pm, except Holidays
Mail form to:
Mission Hospital
Health Information Services
27700 Medical Center Rd.
Mission Viejo, CA 92691
Fax form to:
(949) 365-3889
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 x4781 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 pickup 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.
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