Request Medical Records

Photo of Binders and bound paper stacks

To obtain medical records copies, a signed authorization must be submitted to the Health Information Management department from you or an authorized legal representative.

Online Request

You as the patient or legal representative can complete the Authorization for Use or Disclosure of Health Information form electronically using a smart mobile device. If using a laptop or desktop you can complete the form online, then print, scan and upload the authorization.

Start the Request Process

Mail or Fax Request

You can download a paper copy of the Authorization for Use or Disclosure of Health Information form below. Mail or fax the completed authorization to:

PIH Health Whittier Hospital
12401 Washington Blvd.
Whittier, CA 90602
Attn: HIM Department
Fax: 562.967.2908

PIH Health Downey Hospital
11500 Brookshire Ave.
Downey, CA 90241
Attn: HIM Department
Fax: 562.967.2948

PIH Health Good Samaritan Hospital
1225 Wilshire Blvd.
Los Angeles, CA 90017
Attn: HIM Department
Fax: 562.967.2358

PIH Health Physicians
12401 Washington Blvd.
Whittier, CA 90602
Attn: HIM Department
Fax: 562.967.2938

Processing Time

Please allow 3 to 5 business days for your request to be processed.

If your request was submitted electronically, you will be notified via e-mail or text message with the status of your request.

If the request was submitted in person or mailed, you will receive a phone call from one of our Release of Information team members.

Contact Us

If you have any questions regarding how to complete or submit your request, please contact:

PIH Health Whittier Hospital
Medical Records: 562.698.0811 Ext. 13685
Radiology: 562.698.0811 Ext. 11126

PIH Health Downey Hospital
Medical Records: 562.698.0811 Ext. 26177
Radiology: 562.698.0811 Ext. 25408

PIH Health Good Samaritan Hospital
Medical Records: 213.977.2121 Ext. 8127
Radiology: 213.977.2140

PIH Health Physicians (Clinics)
Medical Records: 562.698.0811 Ext. 13698
Radiology: 562.698.0811 Ext. 11126

Office hours are Monday through Friday from 8 am to 4:30 pm, except Holidays.