The Health Information Management Department (HIM) maintains health records in a private and secure manner and provides this information to patients or legally authorized representatives upon written request within 10 business days for non-emergent requests.
Patient Authorization for the Release of Medical Information form (PDF) is to be filled out (notarized if mailed or faxed) and presented at the HIM Department during regular business hours.
Authorization for Disclosure of the Results of HIV Antibody Blood Test is also to be filled out and returned at the same time.
Please click on the links below to download the forms in a PDF format.
Main Hospital, 1st Floor
9 am to 5 pm
Monday to Friday
Spanish. Interpreter services are available.