Health Records Request
Requests for health records may be submitted by patients, clients, and healthcare professionals. A valid authorization, signed by the patient or patient's representative (such as their power-of-attorney), is required to be completed and on file before releasing any health records. In addition, WellSpace Health must verify the individual identity of the person requesting a health record.
To request a medical record, an Authorization to Release Medical Records form, which is available online and in centers, must be completed and signed.
For Medical Records, click here to complete the Authorization to Release consent form.To request alcohol and drug treatment records, an Authorization and Consent to Release Alcohol and Drug Treatment Record forms, which are available online and in centers, must be completed and signed. Submit the completed authorization form(s) via fax to 916-313-8452 or using the online patient portal. Please contact WellSpace Health by calling 916-737-5555 with questions or for additional support.
For Alcohol & Drug Treatment Records, click here to complete the Authorization & Consent form.Most request are processed in 5-10 business days; some requests may require additional processing time. WellSpace Health staff may contact you by phone or email to verify the information received before the request is processed.