Request for Release of Health Information

If you wish to authorize the release of your health information (medical records) please complete the UCR Health Authorization for Release of Health Information form.

If you wish to authorize UCR Health to obtain your health information (medical records) from an outside provider as a new patient or for continuity of care, please complete the UCR Health Authorization to Obtain Information from Outside Health Care Providers form

When completing either form, please mark only the information that you wish to be released.

Return the completed authorization to one of the following:

  • Your physician’s office
  • Email to:
    roiucrhealth@medsch.ucr.edu
  • Mail to:
    University of California Riverside
    Attention: Medical Records - Mail Code 423
    900 University Avenue
    Riverside, CA 92521
     
  • Fax to:
    951.344.5362

Please allow 2 weeks for processing authorized requests.

For questions regarding submitted requests please call 951.715.7209 for assistance.

You may also access and review your test results, upcoming appointments and communications with your provider by accessing MyChart Patient Portal.

Additional access to your records can be scheduled through the Compliance Office by calling 951.827.4672.