If you’re interested in requesting your health record, please print and sign this form.
Submit your signed form to staff in Medical Reception or fax it to (510) 261-6438 for Oakland and (415) 417-3501 for San Francisco.
We process requests as soon as possible; please allow up to 10 business days.
If you need additional information, please call us at (510) 535-4429 for Oakland and (415) 417-3500 for San Francisco.
Questions? Call or text (510) 535-4400 for Oakland and (415) 417-3501 for San Francisco.