What You Should Know
Healthcare providers are required to obtain signed authorization to release health information (exceptions are outlined in our Privacy Notice). Please use and submit the form appropriate for your request.
Questions can be directed to Health Records at 323.343.3337.
Release of Health Information
This form is used to request the Student Health Center (SHC) release information from your SHC health records to a person/provider/entity of your choosing.
Request for Health Information
This form is used to request health records from an outside provider be released to the Student Health Center (SHC) and incorporated into your SHC health record.