Providing assistance to physicians for completion of patient medical records.
Completing an Authorization
The Health Insurance Portability and Accountability Act, also known as HIPAA, requires hospitals to obtain an original, complete, and properly executed "Authorization for Use or Disclosure of Protected Health Information" form in order to provide a copy of a patient's medical record to a patient or anyone he or she designates. Only the patient, parent/legal guardian, or the patient's legal healthcare representative can sign the form to release medical records.
The authorization form must be legible and complete. Authorizations that are illegible or incomplete will be returned. Requests for information regarding any of the following items must also be specifically initialed on the form:
- Chemical Dependency
- Mental Health
Download the Authorization forms:
Medical Records Request and Submission
During COVID-19, you must call to schedule appointments. Appointments are available Monday, Wednesday and Fridays. Once your "Authorization” form is completed, you may submit your request by mail, fax, or in person. To contact the Health Information Management (Medical Records Department) call (323) 583-1931 ext 6630. We are open Monday-Friday, 8 a.m.-4 p.m. We are closed during lunch from 12 p.m. to 1 p.m.
Community Hospital of Huntington Park
Attn: Health Information Management Department
2623 E. Slauson Ave.
Huntington Park, CA 90255
Records released to a Physician's Office or a Medical Facility are free of charge.
Please note that your medical records do not contain any billing information. For questions about your Community Hospital of Huntington Park’s bill, please call the Central Business Office at (562) 968-5600.
On behalf of Community Hospital of Huntington Park, we sincerely appreciate serving you. We deeply value your relationship with Community Hospital of Huntington Park and we are committed to providing you with the highest level of service because our customers deserve the very best.