Scripps takes great care to ensure your health information is kept private and secure. If you need copies of your medical records for yourself or a third party, we can help.
By completing and submitting the form(s) below, patients can request copies of their medical records or disclosure of that information to someone else.
To request your medical records from Scripps — including radiology reports and images — download, fill out and sign the form below. Be sure to include the dates of service. Without that information, the request cannot be completed.
- Authorization for Disclosure of Health Information (PDF, 200 KB)
- Autorización Para Divulgar Información de Salud (PDF, 180 KB)
To allow a representative to act on your behalf with regard to personal health information, a Designated Personal Representative (PDF, 160 KB) form needs to be completed and signed by the patient.
Please read the forms carefully before you sign them, and be aware that whoever you give your health information to must be responsible for securing it.
Once you have completed the forms, mail, fax or email them to:
Release of Information Center
PO Box 235498
Encinitas, CA 92023-5498
Emails requesting medical records must include a completed Authorization for Disclosure of Health Information form.
Requests from legal offices, copy services and insurance companies must be mailed or served and include the processing fee.
- Continuing care medical record requests: free of charge
- Records for personal, legal and insurance purposes: 25 cents per page
- Copy services or subpoena delivery: $15 processing fee
Requests for records are processed Monday through Friday, 8 am to 4:30 pm. Turn-around time will vary based on staff workload. Our goal is to provide records within 15 days of receiving your request.