Medical Records

St.Vincent requires written authorization for the release of records. You may submit this authorization form in person Monday through Friday between 8:00 a.m. and 4:00 p.m. or mail it to:

Health Information Management
Attn: Release of Information
Saint John's Health System

Please specify the facility as Saint John's or state that records are being requested from all. If you submit the request in person, we also require picture identification.

Associated Fees

The copying fees consist of a labor charge of $20.00. This includes the first ten pages of records, 50¢ per page for pages 11-51 and 25¢ per page for pages 51 and greater. Other charges may apply for postage, stat requests or certifications.

Guidelines for Signatures

Please have your document signed by the appropriate person, based on these guidelines:

• The patient, if eighteen years of age or older, or, if under eighteen, is emancipated or married
• The legally appointed guardian of minority patients (under eighteen years of age)
• The parent having custody of the patient, if the patient is under eighteen years of age, is unmarried, and is under parental control
• If a person is under eighteen years of age, is unmarried and is not in the custody of a parent or legal guardian or is a neglected child, then by the agency of which the child has been made a ward of the Juvenile Court
• If the patient is found incompetent for a reason or reasons other than being a minority, then by the court-appointed guardian; or, if he has been committed to an institution, then by the superintendent of such institution
• The personal representative (executor or administrator) of the deceased patient’s estate; or, if there is no personal representative, the spouse, or if none, an adult child
• The appointed health care representative, provided that evidence of such appointment is received which describes the personal representative’s authority to act for the individual

NOTE: If information concerns a minor treated primarily for drug and/or alcohol abuse, consent need only be given by the minor.

You can download the Request for Information Form online.