A patient, or his/her legal representative, may inspect and/or obtain a copy of their medical records, or have copies of medical records sent to another facility.signed Authorization for Use or Disclosure of Health Information form Washington Hospital Healthcare System requires a completed and signed Authorization for Use or Disclosure of Health Information form before releasing any documents to anyone, including the patient.

How to Request a copy of your medical records:

• Print and complete the Authorization for Use or Disclosure of Health Information form
• The release form must be completed, dated and signed
• Please be sure to include the date(s) of service requested
• We ask that you specify what components of your medical records you wish to obtain/release. Often, the Discharge Summary, Operative Report and History & Physical contain relevant information to suit your needs.
• If you request your complete medical record, there will be a charge of 25 cents/page. There is also a processing time of up to 15 days for a copy of the complete medical record.

If you have any questions regarding release of information, please call 510.818.6629.

You may deliver your forms via email A photo ID is also required, so please be sure to include a color copy of your photo ID with any request.

Please email to: medicalrecords@twinsclinic.com