Dignity Health Southern California medical records

To obtain a copy of your records for yourself, please download and complete one of the forms below:

• English: Patient Access Request Form

• Spanish: Formulario de solicitud de acceso al paciente

If you need your medical or billing records sent to another person or organization, please download and complete the Authorization to Disclose Form:

• English: Authorization to Disclose Form

• Spanish: Autorización para divulgar información

After completing the form, please mail your request or bring it in person to:

Northridge Hospital Medical Center
Health Information Management Department
18300 Roscoe Boulevard
Northridge, CA 91328

You may also fax your completed form to (818) 775-0953. Questions? Please call (855) 396-0017 (ext. 22980).

To obtain a copy of your records for yourself, please download and complete one of the forms below:

• English: Patient Access Request Form

• Spanish: Formulario de solicitud de acceso al paciente

If you need your medical or billing records sent to another person or organization, please download and complete the Authorization to Disclose Form:

• English: Authorization to Disclose Form

• Spanish: Autorización para divulgar información

After completing the form, please mail your request or bring it in person to:

St. Bernardine Medical Center
Health Information Management Department
2101 N. Waterman Ave.
San Bernardino, CA 92404

You may also fax your completed form to (909) 881-4547. Questions? Please call (909) 881-4358.

To obtain a copy of your records for yourself, please download and complete one of the forms below:

• English: Patient Access Request Form

• Spanish: Formulario de solicitud de acceso al paciente

If you need your medical or billing records sent to another person or organization, please download and complete the Authorization to Disclose Form:

• English: Authorization to Disclose Form

• Spanish: Autorización para divulgar información

After completing the form, please mail your request or bring it in person to:

St. Mary Medical Center
Health Information Management Department
1050 Linden Ave
Long Beach, CA, 90813

You may also fax your completed form to (562) 491-4889. Questions? Please call (562) 491-9941.

Birth certificates

Birth certificate information for a child less than one year old may be obtained by calling our birth clerk at (562) 491-9303. If the child is older than one, you will be referred to the Los Angeles County Hall of Records, Norwalk, CA which may be reached by calling (562) 462-2137, or you may order a certified copy of the birth certificate online.

For medical record requests pertaining to Dignity Health Medical Group clinics, please contact us directly. We are here to help you get the information you need in a secure and timely manner.

• DHMG Northridge: (818) 885-5480, option 3
• DHMG Inland Empire: (805) 419-7732

You can view a summary of your medical records anytime through our secure online patient portal. This includes information like your lab results, medication history and upcoming appointments. It’s a convenient way to stay informed about your health.