Request for Release of Health Information

Requesting medical health records? Review all options before selecting one of the following,

I need records from the following facility,

I Am  


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For any inquiries regarding release of health information from UCR Student Health Services, please contact UCR Student Health Services on UCR Campus at (951) 827-3031.
 
For more information about UCR Student Health Services, please CLICK HERE.
 
PLEASE NOTE: UCR Health is not UCR Student Health Services
 


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Inquiries for release of health information from UCR Health Family Center (Palm Springs), please contact the office,
  • PHONE (760) 561-7373
  • FAX  (760) 327-5140
PLEASE NOTE: “UCR Health – Family Center” is not operated by UCR Health,
but operated by Tenet Health/Desert Care Network
 

Authorization-for-Release-of-Health-Information.pngI am a current or past patient of UCR Health, provider or hospital

STEP 1 - Download, complete and sign form
  • Click to download and print the UCR Health Authorization for Release of Health Information form.
  • If you are not able to download and print the appropriate form, stop by any UCR Health location to pick up the correct form

STEP 2 - Send in the completed form
  • We want to make it easy to submit your completed form. There are 4 ways to get us your completed form.  
E-Mail roiucrhealth@medsch.ucr.edu
Fax (951) 344-5362
Mail UCR Health
ATTN: Medical Records - Mail Code 423
900 University Avenue
Riverside, CA 92521
Drop Off UCR Health – Multispecialty Clinic
UCR Health – Psychiatry Clinic
UCR Health – Neurosurgery
UCR Health – Women’s Health
U
CR Health - Pediatric Clinic
 
*Please allow 2 weeks for processing authorized requests

Authorization-for-Release-of-Health-Information-(1).pngI am a new, referred, or transferred patient to UCR Health

STEP 1 - Download, complete and sign form
  • Click to download and print the UCR Health Authorization for Release of Health Information form.
  • If you are not able to download and print the appropriate form, stop by any UCR Health location to pick up the correct form

STEP 2 - Send in the completed form
  • We want to make it easy to submit your completed form. There are 4 ways to get us your completed form.  
E-Mail roiucrhealth@medsch.ucr.edu
Fax (951) 344-5362
Mail UCR Health
ATTN: Medical Records - Mail Code 423
900 University Avenue
Riverside, CA 92521
Drop Off UCR Health – Multispecialty Clinic
UCR Health – Psychiatry Clinic
UCR Health – Neurosurgery
UCR Health – Women’s Health
UCR Health - Pediatric Clinic
 
*Please allow 2 weeks for processing authorized requests


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If you are requesting medical and/or billing records, please include a $15.00 processing fee (check only) made payable to Regents UC and serve the request:
 
In Person Mail
Located in Citrus Tower
UCR Health – Multispecialty Clinic
3390 University Avenue, STE 100
Riverside, CA 92501  
UCR Health
ATTN: Medical Records - Mail Code 423
900 University Avenue
Riverside, CA 92521
 
PLEASE NOTE: UCR Health will not have Diagnostic Imaging. UCR Health patients are referred to imaging centers

*Please allow 2 weeks for processing authorized requests


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Questions For questions regarding submitted requests, please call 1.951.715.7209
MyChart Patient Portal You may also access and review your test results, upcoming appointments and communications with your provider by accessing MyChart Patient Portal.
Compliance Office Additional access to your records can be scheduled through the Compliance Office by calling 951.827.4672.

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Health Information Management Office

UCR Health
ATTN: Medical Records - Mail Code 423
900 University Avenue
Riverside, CA 92521

M-F 8am to 4:30pm

Phone 1.844.827.8000
Fax 1.951.344.5362

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