Obtaining Your Medical Records - UCSF Department of Psychiatry 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's name and date of birth in the designated fields. This information is crucial for identifying the correct medical records.
3. Indicate your relationship to the patient by checking the appropriate box, such as 'Patient', 'Parent of the minor patient', or 'Guardian'.
4. Select the type of access you are requesting. You can choose between supervised inspection or copies of specific documents like discharge summaries or progress notes.
5. If requesting copies, specify which documents you need and their corresponding dates. Use the text fields provided for clarity.
6. Fill out your contact information, including your name, phone number, and address. Ensure this is accurate for any follow-up communication.
7. Sign and date the form at the bottom before submitting it. Remember to include any required documentation if you are a guardian or conservator.

Start using our platform today to easily fill out and submit your medical records request!