Health Information Management

IMPORTANT COVID-19 UPDATE: All in-person medical record requests have been temporarily placed on hold and our offices are closed to the public due to COVID-19 precautions. Please submit a request through one of our electronic options or mail-in the request. Thank you for your understanding!

Previously known as Medical Records, the Health Information Management (HIM) Department at Adventist Health Glendale is responsible for gathering, storing and managing the medical records of current and former patients. HIM team members help to ensure that each medical record is accurate, timely, complete and secure.

Above all else, the department is responsible for protecting the privacy of all personal health information. That includes carefully controlling the release of patient information so that only individuals and entities that have a legal right to view information may gain access to it.

How to Get a Copy of Your Medical Record

Step 1. You must submit and fill out a release form (“Authorization to Release or Inspect Patient Health Information”). There are three ways to get access to this form:

  • Online - Release Form (English)
  • Online - Release Form (Spanish)
  • Online - You can view the blank form with Adobe’s Acrobat Reader, print it out, and fill it in by hand.
  • In person at the address listed below. Our office is open Monday through Friday between 8:00 a.m. and 5:00 p.m.
  • By phone—Call the Health Information Management office at (805) 955-6820, Monday through Friday, between 8:00 a.m. and 5:00 p.m. Our staff can mail, email or fax an authorization form to you.

Step 2. The authorization form must be filled out either by the patient or the patient’s legal representative. If the medical record you’re requesting is your own, you must provide current government-issued ID.

If you are requesting a medical record for another person, you must submit that person’s current government-issued ID and your own identification.

Step 3. Submit your completed release form. (See contact information below.)

In order for your request to be valid and processed, please be sure to fill out all fields on the medical records release form. Otherwise if it will be considered incomplete and invalid and we cannot process.

Cost and Timing

The charge for a medical record depends in the source of the request:

  • Insurance company or attorney—charges vary
  • Your physician or patients for continuation of care —no charge

Personal requests for medical records are typically fulfilled within 14 business days.

Contact Information

Our Physical Address:

Health Information Management
3015 N. Sycamore Drive
Simi Valley, CA 93065
Map. Note that we are located on the North Campus of Adventist Health Simi Valley, one block north of the main campus.

Our Mailing Address:

Adventist Health Simi Valley
Health Information Management
2975 N. Sycamore Dr.
Simi Valley, CA 93065

Phone: (805) 955-6820
Fax: (805) 955-6824
Office hours: 8:00 a.m. to 5:00 p.m.

Related Requests

Diagnostic Images/X-rays. Health Information Management does not process requests for copies of diagnostic images, such as X-rays, MRI scans and CT scans. If you need to get a copy of your diagnostic image, visit our Diagnostic Images Request page to learn more.

Birth Certificates. For questions about birth certificates, call Adventist Health Simi Valley’s birth certificates office directly at (805) 955-6303.

Hospital Bill. If you have a question about your Adventist Health Simi Valley bill, call (805) 955-6450 or visit our Financial Services pages. Please note: If you have a question about your physician’s bill, contact your physician’s office directly.

Link to the Medical Records Release Form

Please click here to open a copy of release form using Adobe’s Acrobat Reader.

If you do not have a copy of Adobe’s Acrobat Reader, then you can obtain one by clicking here.