Medical Record Copy Request

Did you know that Kaiser Permanente keeps your medical records electronically? This means that your personal care provider can easily access most of your important health information and tests without your chart.

If you're a new member, we recommend that you discuss with your personal physician what pertinent records he or she may need to continue your care. It may not be necessary for all of your records to be transferred from your previous non-Kaiser Permanente physician.

New members should receive a Medical Record Number from Kaiser Permanente before completing an Authorization for Disclosure Form and transferring medical records. Call the Member Services Call Center if you need assistance with obtaining a medical record number at 1-800-464-4000.

For obtaining copies of your Medical Records for your personal use or a third party, our office will need:

• A completed Authorization for Disclosure Form

• A completed AB610 Form

• A copy of your or the patient's Photo I.D.

Please Note:

• When completing the Authorization for Disclosure Form, be sure to indicate to whom the records are being released (even if this is yourself).

• Please print and sign your completed Authorization for Disclosure Form and AB610 Form.

• There also may be fees applicable for medical record copies in the amount of $0.25 per page copied.

• If you wish to review your medical record without obtaining copies, submit an Authorization for Disclosure Form and an AB610 Form.
  Once received, you will be contacted within 5-days to set-up an appointment with one of our staff.

• For copies of your records, you may either mail or fax the completed forms to our office. Once received, you will be notified upon completion, within 2 weeks.