Medical Record Request

Access to Patient Information and Third Party Request for Release of Information by NEVHC

As our patient, your health information and privacy are valued by NEVHC. We will not release or otherwise divulge information about you or your health without your permission unless we are permitted or required to release information pursuant to a legal action or a government mandate

Frequently Asked questions

Please review the NOTICE OF PRIVACY PRACTICES for all the ways NEVHC uses and limits your health information. This document will also provide guidance on times when we are mandated to provide information about you to third parties. It also explains how you may opt out of some forms of information sharing. For a summary of the Notice of Privacy Practices click here.

Yes, there are costs. For paper records, NEVHC charges a $15 administrative fee plus a copying fee of 25 cents per page up to 200 pages, after which the fee is 12 cents per page. The maximum fee is $400. If you want just a few pages of your record, NEVHC provides patients with up to five pages of copies at no charge. If your health information is released on a CD, the maximum fee is $6.50 for EHI. Fees for mailing may also be applied. If you have access to the NEVHC portal, you may access your record at no cost, and you may view or download those parts of your record. You can also request medical records to be sent to you via your patient portal.

As per CA law, NEVHC will release the relevant portion of your record for your appeals case at NO CHARGE to you. Fees may apply if your request is being handled by an attorney’s office who is requesting records on your behalf. You can also access most parts of your record on the patient portal

If you are being referred by NEVHC to a specialist, we will automatically send relevant information about your care or treatment to that provider so long as you have verbally consented to the referral. If you are requesting your health information to be released to other providers or third parties, you must authorize the release of this information in writing by completing an AUTHORIZATION TO RELEASE INFORMATION form. You may return the form to the Business Office or Medical Records department of your NEVHC health center. You may also FAX the form to our Medical Record Coordinator’s office at (818) 270-9271.

If you have any questions or concerns about information in your medical or dental record at NEVHC, you may call your health center to make an appointment to speak or meet with your provider. As another option, you may contact the NEVHC Privacy Officer to discuss available options at (818) 898-1388 ext. 41645.

For questions about the release of medical information, contact the Medical Records department at your health center location. For general information, you can call the Medical Records Program Coordinator at (818) 898-1388 ext. 52202 or email: medicalrecords@nevhc.org

NEVHC has a HIPAA Privacy Officer whose job it is to thoroughly research all allegations related to breaches of patient confidentiality. You may call the Privacy Officer at (818) 898-1388 ext. 41645. The Privacy Officer is also responsible for reporting those breaches to government entities on your behalf as required by law.

Third party Releases:

NEVHC contracts with an offsite vendor, Iron Mountain, in Denver, CO, to manage the release of all non-patient requests.

General Information:

To request records, please use one of the following methods:

• MAIL request to: Northeast Valley Health Corporation, 1600 San Fernando Rd., San Fernando, CA 91340


• FAX Requests to: (818) 270-9271


• PRESENT a subpoena or court order to: 1600 San Fernando Rd, Bldg A, San Fernando, CA 91340—ask for the Medical Records Program Coordinator.


•EMAIL questions: medicalrecords@nevhc.org

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