Keck Medicine of USC now offers 24/7 access to your medical records. Send secure messages to your physician, access test results and request prescription renewals and appointments from your personal computer or smartphone via the patient portal at http://myuscchart.keckmedicine.org/.

Alternatively, you may contact us at 800-USC-CARE (800-872-2273).

Overview

Our goal at Keck Medicine of USC is to make obtaining your health information a simple, secure and expedient process. To obtain your information, follow these steps:

1. Complete an Authorization to Release Protected Health Information (HIPAA Authorization form)
2. Submit it to one of our locations by fax, mail or in person

Detailed information

• Obtain a HIPAA form at one of our offices or online by downloading it here.
• Submit the completed form by mail, fax or in person to your local Keck Medicine of USC clinic or one of the hospital locations listed below. If you are unsure which location to submit to, please direct it to Keck Hospital of USC.

• NOTE: Keck Medicine of USC clinics can only provide records for their own location to you, the patient. If you are a personal representative/legal guardian or need a more comprehensive record set, please contact one of the three hospital locations.

If you need help completing the form, Medical Records staff will be able to assist you. For requests made in person, please bring your photo ID if you are the patient or recipient. If you are the legal guardian, please bring supporting paperwork. For mailed or faxed requests, please make sure your signature matches your most recent visit (or include a copy of your photo ID).

Please read the information below in the “Important Information About Requesting Medical Records” section and ensure that all sections of the authorization are completed.

Timeframe

Please allow reasonable time to process your request. The legal maximum time to fulfill requests is 15 days, but we strive to process requests sooner than that. We will contact you if we experience delays or are unable to fulfill your request.

Locations and scope of request

Our hospitals are set up to accommodate requests for all Keck Medicine of USC locations. Should you wish to receive records for all locations, please direct your request to one of the hospitals. You also may submit a request directly to one of the USC Care clinics if you only need records from that location.

Important notice about completing authorization form

The HIPAA form is a document required by California and Federal law. It allows us to release records to your designated recipient, but it must be completed fully and accurately. Your request will be delayed if the below are not completed:

• Patient Information:
  • Patient’s full name (list any and all names the patient may have used)
  • Patient’s date of birth
• To whom the records will be released (name and full address)
• Purpose for which the information may be disclosed (e.g., continuity of care, legal matter, personal use)
• The specific health information being requested:
  • Dates of service
  • Type of reports/information
• Patient’s signature or legal representative’s signature

Authorizations signed by a personal representative (someone other than the patient) must be verified by including a copy of one of the following documents:

• Legal guardianship papers
• Advance Directive/Healthcare Power of Attorney, for patients unable to make healthcare decisions
• Designation of Personal Representative, which allows the representative to act on the patient’s behalf with regard to personal health information

Requests for medical records of deceased patients require a copy of the death certificate or evidence of next of kin or executorship of the estate. Records can be released to anyone whom the patient authorizes (in writing) to receive them. If the authorization’s expiration date is not noted, the authorization will be valid for 90 days.

Medical record requests for personal use may be subject to a fee. The first two years of pertinent information are provided at no cost. Additional portions or copies are charged at $0.25 per page.

Records related to medical emergencies or for continuity of care are faxed free of charge directly to a physician or medical facility. If you need records to be sent to another provider, the simplest process is to have that office submit a fax cover letter with your name, date of birth and the information they need to one of the above fax numbers. We do not require a signature for such requests, and those usually are addressed within 15 minutes.

Pertinent information such as radiology/imaging reports, history and physical, consultations, operative reports and discharge summaries are routinely provided to the primary care physician for continuing care.

If you need to obtain radiology images, please contact the respective radiology location below:

• Keck Inpatient Radiology Department: 323-442-8700
• Keck Outpatient Radiology Department: 323-442-7451
• Norris Radiology Department: 323-865-3219
• Verdugo Hills Radiology: 818-952-2266

L.A. County Registrar-Recorder/County Clerk

Contact number: 800-201-8999

Website:  http://lavote.net/home/records/birth-records/birth-records-request

L.A. County Registrar-Recorder/County Clerk

Contact number: (800) 201-8999

Website: http://lavote.net/home/records/death-records/death-records-request/who-can-obtain-a-death-certificate-copy

To ask for an amendment (a change), download the REQUEST TO AMEND PROTECTED HEALTH INFORMATION: http://policy.usc.edu/files/2014/07/Request-to-Amend-Form.pdf

If you cannot download this form, please call 323.442.8786 and we will mail or fax a copy to you.

When you have completed, signed and dated the form, please fax it to or send it to the following address:

Keck Hospital of USC
Attn: Medical Records
1500 San Pablo, Rm #1206
Los Angeles, CA 90033
Fax: 323-442-8520
Monday–Friday, 8 a.m.–4:30 p.m.