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Medical Record Release of Information Department

release
Mailing Address:
1300 Crane Street
Menlo Park, CA 94025-4283
Contact Phone: (650) 498-6166
Fax: (650) 324-9447
Days and Hours:
Monday - Friday
8:30 am - 12:30 pm,
1:30 pm - 5:30 pm

 

MyHealth Proxy Access for Parents Now Available!

MyHealth Proxy Access for parents and guardians is a convenient, efficient way for you to stay on top of your minor child's medical care. Once you've registered for MyHealth's Proxy Access, you will have a range of online options, including the ability to view your child's upcoming appointment schedule, lab results, radiology results, immunization records, and send non-urgent messages directly to your pediatrician's office. Learn more
 

Requesting Medical Records

Patients, or their legal representative, may inspect or obtain copies of their Menlo Medical Clinic (MMC) medical records or have copies sent to another medical facility.

Before MMC allows inspection or provides a copy of a patient's records to anyone (including the patient or their representative), Menlo Medical Clinic is required under the State of California's Confidentiality of Medical Information Act to obtain an original, complete and properly executed Authorization for Disclosure of Health Information. Please print and complete the release form in English or Spanish:

Once you have fully completed the form, you have three ways to get the completed form back to us.

  1. In Person. Bring the form to: Medical Records Department

    Release of Information Desk
    1300 Crane Street, 3rd Floor
    Menlo Park, CA 94025

  2. By Mail. Please mail to the above address.
  3. By Fax. Please fax to (650) 324-9447.

    Please allow 10 working days, excluding holidays for processing.

Requesting Radiology Images

Patients, or their legal representative, may inspect or obtain original or copies of their imaging studies performed at Menlo Medical Clinic (MMC) or have them sent to another medical facility.

Before MMC allows inspection or provides a copy of a patient's records to anyone (including the patient or their representative), Menlo Medical Clinic is required under the State of California's Confidentiality of Medical Information Act to obtain an original, complete and properly executed Authorization for Disclosure of Health Information. Please print and complete the release form in English or Spanish:

Once you have fully completed the form, you have three ways to get the completed form back to us.

  1. In Person. Bring the form to:
        MMC Radiology Department
        1300 Crane Street, 1st Floor 
        Menlo Park, CA 94025
  2. By Mail. Please mail to the above address.
  3. By Fax. Please fax to (650) 329-0586.

    Please allow 3 working days, excluding holidays for processing.