Medical Records Release Form

Requesting Your Medical Records

Under HIPAA, you have the right to access and receive a copy of your medical records held by TruCare Health. To protect your privacy, we require a signed Authorization for Release of Health Information before any records are copied, transmitted, or shared with a third party — such as another provider, an attorney, an insurer, or a family member.

How to Submit a Request

1. Download and complete the Request for Records form. Fill out every field, including the specific records requested, the date range, and where the records should be sent.
2. Sign and date the form. Requests submitted on behalf of another patient must include legal documentation of authority (power of attorney, guardianship, or parental relationship for minors).
3. Return the signed form to our office by secure email, fax, or in person. Our team will verify your identity before processing.

Processing Time & Fees

Standard requests are completed within 15 business days of receipt. Records sent directly to another treating provider are provided at no cost. Copies sent to patients, attorneys, or third parties may include a reasonable, cost-based fee for retrieval, copying, and delivery, as permitted by California law and HIPAA. You will be notified of any applicable fee before records are released.

Questions

Call our office at (714) 532-6713 or visit our contact page for help completing the form or checking the status of a pending request.