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Request Medical Records

Medical Records Department Information

Hours: Monday – Friday, 8 a.m. – 4:30 p.m.

Phone: 951-845-1121, ext. 6205

FAX: 951-769-2113

The medical records department maintains medical patient data in a secure manner, allowing release only to recognized entities with a legal right to review the contents.

Please Note: The medical record is the property of the hospital. The patient does not automatically receive a copy of his/her medical record upon discharge from the hospital. Medical records must be completed by all physicians involved in the patient’s care prior to being copied and released to the patient. The patient may request to receive a copy of his/her medical record, upon completion of the appropriate authorization. A fee may be involved.

Medical Records Requests

Information about you and your health is confidential.

To obtain a copy of your medical records, please follow the instructions below:

  • Download, complete and print the authorization form below.
    • Authorization for Disclosure of Health Information form (English OR Spanish)
    • Please note: Unsigned requests will not be processed.
Release of Information Form (English)Release of Information Form (Spanish)


Completed forms can be:

  • Dropped off at Medical Record Department
  • Mailed to:
    San Gorgonio Memorial Hospital
    600 N. Highland Springs Ave.
    Banning, CA 92220
  • Faxed to: 951-769-2113 Attn: Release of Information

Frequently Asked Questions

Q: May my spouse request and receive copies of my medical record? 

A: With a signed Authorization for Disclosure of Health Information form from the patient, another person may request and receive copies of a patient’s records.

Q: When can I expect to receive my copies? 

A: It may take up to 5 business days to fulfill your request.

Q: Can the copies be mailed to me? 

A: Copies will be mailed to the address specified on the Authorization for Disclosure of Health Information form or you may pick them up during hours of operation.

Q: I am a copy service or process server, when can I come to medical records for requests? 

A: Copy services and/or process servers are able to come between the hours of 8:30 a.m. – 4 p.m.