Keck Medicine of USC provides multiple ways to obtain your medical records. Our most popular method is through myUSCchart, our patient portal, but you also may obtain records through our HIPAA-compliant authorization form.
Your rights regarding your health information
Below are listed your rights as a patient to access your health information:
- Right to request access to your health information
- Right to request amendments to your health information
- Right to revoke your authorization
- Right to an accounting of disclosures of your health information
- Right to request how information is provided to you
- Right to request restrictions on the use of your health information
- Right to be notified of a breach
- Right to a paper copy of this notice
Download USC’s Notice of Privacy Practices here.
Please read the information below to review your options.
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 https://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:
- Complete an Authorization to Release Protected Health Information (HIPAA Authorization form)
- 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.
Attn: Medical Records
1500 San Pablo, Rm #1206
Los Angeles, CA 90033
Phone: 626-293-2400
Fax: 323-865-5482
Monday–Friday, 8 a.m.–4:30 p.m.
1441 Eastlake Ave.
Los Angeles, CA 90033
Phone: 626-293-2400
Fax: 323-865-5482
Monday–Friday, 8 a.m.–4:30 p.m.
1812 Verdugo Blvd.
Glendale, CA 91208
Phone: 626-293-2400
Fax: 323-865-5482
Monday–Friday, 8 a.m.–4:30 p.m.
- 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.
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.
- 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: https://lavote.net/home/records/birth-records/birth-records-request
L.A. County Registrar-Recorder/County Clerk
Contact number: (800) 201-8999
To ask for an amendment (a change), download the REQUEST TO AMEND PROTECTED HEALTH INFORMATION: https://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: 323-865-5482
Monday–Friday, 8 a.m.–4:30 p.m.