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Release of Medical Information


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All requests for copies of medical records must be received in writing. For a HIPAA compliant authorization form to request release of medical information to someone other than yourself, please call us at (650) 367-5586. If you wish to have copies of your own records, a patient access form will need to be completed. Learn more about the patient access process by reading our patient access brochure.

To avoid delays, please review the applicable form carefully and complete all sections. If the patient is a minor (less than 18 years of age), in most cases, a parent or legal guardian must sign. Questions regarding release of information or the completion of the pre-printed form, may be directed to the Release of Information (ROI) Technician at (650) 367-5141, Monday - Friday, 8:30 A.M. - 4:00 P.M.

Mail Completed Form to:
Sequoia Hospital / HIM Department - Release of Information
170 Alameda de las Pulgas
Redwood City, CA. 94062

Urgent patient care requests may be faxed to (650) 482-6176, attention ROI Technician.

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