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Medical Records Office


Phone: 714.999.6126
Fax: 714-999-6165
Hours: M-F 8:00-4:30 (closed major holidays)

Requests for Medical Records

To begin the process of obtaining copies of your medical records, please print and complete the
Patient's Request for Access to Protected Health Information.

If you need to have copies of your record released to another individual or hospital, please print and complete the form entitled Authorization for Use or Disclosure of Protected Health Information.

Click here for English Form
Click here for Spanish Form
In order for Health Information Management to process your request, all information requested must be provided.

Please fax your completed form(s) to 714.999.6165 or mail to:

AHMC Anaheim Regional Medical Center
ATTN: Health Information Management
1111 W. La Palma Ave.
Anaheim, CA 92801

If you are unable to print the above forms, please call the Health Information Management Office at 714.999.6165

Once your request is received by Health Information Management, it will be mailed to you unless arrangements are made to pick up your copy.

Medical records will be faxed or mailed to another hospital or physician's office if requested by a completed Authorization for Use or Disclosure of Protected Health Information.

A spouse, relative or friend cannot obtain a copy of your medical records, or pick up records for you, unless the individual has Power of Attorney for Healthcare Decisions for you. A copy of the Power of Attorney for Healthcare Decisions must be included with your request.

The pertinent part of the medical record is available to patients at no charge. This includes the discharge summary, history & physical, consultations, procedural reports, radiology (diagnostic imaging) and laboratory reports.

For copies of additional portions of the medical record, a fee of 25 cents per page will be charged to you. A bill may be mailed prior to the records being copied and sent to you. Money orders will be accepted via mail made out to AHMC Anaheim Regional Medical Center. There is no charge if the copies of the records are sent to physicians for your follow up care or treatment.

Birth Certificates

Birth certificates are created at the hospital and sent to the State of California for issuance. Contact the State of California, or local county, registrar recorder's office to obtain a birth certificate.

If the child is under one year of age, you may request a copy from the Orange County Clerk-Recorder Office The phone number is 714.834.2500.

Information can be obtained on their website at ocrecorder.com. The fee for a birth certificate is $28.

If you cannot apply in person, you may request an application in writing.

Send a letter with your name, your baby's name, your baby's date and place of birth to:

Orange County Clerk-Recorder
Attn; Vital Records
12 Civic Center Plaza, Room 106
Santa Ana, CA 92701

You will need to send a notarized statement with the application and the fee (check or money order to the Department of Health and Human Services) to the above address.

If the child is over one year of age, a copy of the birth certificate can be requested from Orange County Clerk-Recorder Office. Please address your request to:

Orange County Clerk-Recorder
Attn: Vital Records
12 Civic Center Plaza, Room 106
Santa Ana, CA 92701

The website is ocrecorder.com.

For more information, contact General Information at 714.834.2500.

Death Certificates

Information on obtaining death certificates may be obtained from Orange County Clerk-Recorder Office. The fee is $21 and pertains to County Deaths only from the year 1994 - present.
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