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    Request Your Medical Records

    Medical Records Release Form



    woman looking at computer

    You have the right to review and receive copies of your medical records, subject to legal restrictions and any appropriate copying or retrieval charge(s). You can also designate someone to obtain your records on your behalf. Sutter Health will not release your medical information without your written consent, except as required or permitted by law.

    Please allow up to fifteen (15) calendar days to receive copies of your medical records after receipt of your written request.

    In most cases, there are no fees for receiving copies of your medical records. You will be notified in advance if any fees apply prior to releasing your records.

    To receive or release copies of your medical records, please download and complete the Sutter Health authoriziation release form:

    Download the Authorization Release Form | PDFOpens new window*

    Complete the Authorization Release Form Electronically

    1. Open the form in Adobe Acrobat Reader. (Download a free copy of Acrobat Reader)Opens new window
    2. Complete the form by typing in your responses in Acrobat Reader
    3. For the section “Authorization”, choose the facility where you received care from the drop down arrow at the end of the first line (Name of hospital, physician or health care provider). If you are requesting records from a medical foundation or clinic, please add the physician’s name to this line.
    4. Print out the completed form. Sign and date the form manually.
    5. Mail or fax the form to the address or fax for the selected facility.
    6. Please complete and submit an Authorization form for each Sutter affiliate where you received care.
    Complete the Authorization Release Form by Hand
    1. Download the PDF form and print it out.
    2. For the section “Authorization”, you’ll need to write in the name of the facility where you received care (Refer to the list of facilities on page 4 of the PDF ). If you are requesting records from a medical foundation or clinic, please add the physician’s name to this line.
    3. Complete the form, sign and date.Mail or fax the form to the address or fax for the selected facility.
    4. Please complete and submit an Authorization form for each Sutter affiliate where you received care.