Medical Records

 

We are here to provide you with your medical records, and strive to fulfill your request timely while ensuring your privacy. The following information will help guide you in the options available and provide FAQs and contact information if you have any questions.


Obtaining Your Medical Records

Option 1: Request medical records via myUCLAhealth or MyStudentChart

Requests can only be accessed via PC. Mobile devices are not supported at this time.

1.      How to submit a request for your medical records via:

  • myUCLAhealth (for UCLA Health records)

    • If you have not signed up for myUCLAhealth, go to How to Sign Up for myUCLAhealth for instructions.
    • Log in to myUCLAhealth.
    • To request your medical records, follow the steps outlined here.
    • For instructions on how to download requested records, click here.
    • For assistance with your myUCLAhealth account, call 855-364-7052.
  • MyStudentChart (for Arthur Ashe Student Health and Wellness Center and Counseling and Psychological Services (CAPS) records)

    • Log in to MyStudentChart.
    • For instructions on how to request your medical records, click here.
    • For assistance with your MyStudentChart account, call 310-825-4073 (Option 8).

Option 2: Follow this link to complete the medical record authorization form electronically.

  1. Have your photo identification ready and follow the prompts.
  2. Once completed the form will be sent to our HIM team directly.

Option 3: Download and print the authorization for Release of Health Information form.

  1. Download and print the authorization form for Release of Health Information for Patient or a third-party (i.e. Non-UCLA Provider, Insurance Company, Attorney, etc.).
  2. Complete and sign the form. 
    Please Note: electronic signatures are not accepted at this time.
  3. Submit completed form via email, fax, or mail. 
    Email: [email protected] 
    Fax: 310-983-1468 
    Mail: 
    UCLA Health 
    Health Information Management Services 
    10833 Le Conte Ave., CHS, BH-902 
    Los Angeles, CA 90095 

    Please note: Unsigned and/or incomplete requests will not be processed and will be returned to requestor.

Medical Record Copy Fee

UCLA Health will invoice you for the production of records, and will invoice you by mail/email. Please see our Frequently Asked Questions.

Contact Information

Business Hours: 8:00 am to 4:30 pm, Monday to Friday 
Phone: 310-825-6021 
Fax: 310-983-1468 
Email: [email protected] 
Mailing Address: 
UCLA Health 
Health Information Management Services 
10833 Le Conte Ave., CHS, BH-902 
Los Angeles, CA 90095

STAT Request

(For physicians and hospital use only)

If you are a physician or hospital and your request is urgent, please fax your request to 310-206-4831.

Requesting Additional Information

If you are requesting additional information such as radiology imaging, pathology slides, or billing information, please contact the corresponding department below directly:

Request to Amend your medical record

Option 1: Request to amend or add an addendum to your health record via myUCLAhealth or MyStudentChart

Requests can only be accessed via PC. Mobile devices are not supported at this time.

1. How to request an amendment or add an addendum to your health record via:
  • myUCLAhealth (for UCLA Health records)
  • MyStudentChart (for Arthur Ashe Student Health and Wellness Center and Counseling and Psychological Services (CAPS) records)
    • Log in to MyStudentChart
    • For instructions on how to submit a request, click here.
    • For assistance with your MyStudentChart account, call 310-825-4073 (Option 8).

Option 2: Download and print the amendment form to Request to Amend Protected Health Information (PHI)

  1. Download and print the Request to Amend Protected Health Information (PHI) form
  2. Complete and sign the form. 
    Please note: electronic signatures are not accepted at this time.
  3. Submit completed form via email, fax, or mail. 
    Email: [email protected] 
    Fax: 310-794-1616 
    Mail: 
    UCLA Health 
    Health Information Management Services 
    10833 Le Conte Avenue., CHS BH-921 
    Los Angeles, CA 90095

For additional information, visit our Frequently Asked Questions.