How to Request a Copy of your Medical Record
Health Information Management (HIM) is located in Orange at St. Joseph Health
(There is no longer an office located at Mission Hospital)
Patients, or their legal representative, may inspect, obtain copies of
or have copies of their Mission Hospital medical records sent to another
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 Access Your Medical Records Online
You can now access and download your health information from you latest
hospital stay online through the FollowMyHealth patient portal. For more
information about the patient portal,
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 Viejo or Laguna Beach
- Indicate the type of records needed
- Radiology images (CD)
- 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 (714) 771-8167.
Submitting a Request
Once the authorization form has been completed the request can be submitted
by one of the following methods.
Mail/fax form to:
Health Information Management
Release of Information
St. Joseph Hospital Orange
1100 West Stewart Drive
Orange, CA 92868
(714) 744-8679 Fax
Attn: Release of Information
Other Important Information About Inspecting or Requesting a Copy of Your
You may only inspect records within the Health Information Management
at St. Joseph Hospital in Orange 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 (714) 771-8167 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.
If the reproduction charges are greater than $100, then pre-payment will
be required before your records can be mailed. There is a $5 charge for a CD.
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 medical office.
Please allow 5 - 10 working days for your request to be processed. You
will be contacted by the Health Information Management office when your
records are ready for pick-up or mailing.
Picking Up Your Requested Medical Records
If you plan to come to the Health Information Management office in Orange
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.