List of Forms and Contact Details Required to Request Medical Records From UCLA Health (2026)
UCLA Health runs one of the largest academic medical systems in Southern California, including Ronald Reagan UCLA Medical Center, UCLA Medical Center Santa Monica, Jules Stein Eye Institute, and Resnick Neuropsychiatric Hospital. For personal injury attorneys, getting records means knowing which department to contact and which form to submit. UCLA routes certain records to separate departments, so it's easy to send a request to the wrong place and wait weeks for nothing. Codes Health manages the whole retrieval process, from authorization validation to persistent follow-up across UCLA's departments.
Key Takeaways
UCLA Health processes record requests within 15 business days of receipt
Three request pathways: myUCLAhealth, a secure online authorization, or the downloadable form by email, fax, or mail
UCLA Form #30910 defaults to expiring 12 months after signing when the expiration field is blank, and UCLA does not accept electronic signatures on it
Resnick accepts authorizations by email, but neuropsychiatric records are not delivered by email
Arthur Ashe Student Health holds Ashe Center records for appointments before July 8, 2025
Fees depend on the legal basis; patients requesting their own records are told there is no fee
Codes Health validates authorizations before submission, follows up across channels, and verifies completeness before delivery
Understanding the UCLA Health Medical Records Request Process
Why You Might Need Your UCLA Health Records
PI cases need documentation to establish damages, prove causation, and support demand calculations: emergency department visits, specialist consultations and imaging, surgical and hospitalization records, billing statements, and mental health treatment documentation.
The complication is that UCLA keeps separate departments for different record types. A general request to Health Information Management Services (HIMS) won't pull mental health, dental, or radiology images without additional contacts.
Overview of the Request Journey
UCLA describes three request options: request through myUCLAhealth or MyStudentChart, complete a secure online authorization, or download the paper form and submit it by email, fax, or mail. UCLA says requests are processed within 15 business days of receipt, and that unsigned or incomplete requests will not be processed and will be returned.
That return-and-resubmit cycle is where firms lose time, and incomplete or defective authorizations are a leading preventable cause of rejected requests.
Codes Health's AI review catches these errors before submission, flagging misspellings, missing dates of service, and signature issues that otherwise cause rejections. It's built for the authorization requirements health systems like UCLA enforce.
Navigating UCLA Health's Official Medical Records Request Form
Key Sections of the Request Form
UCLA Form #30910 is a two-page fillable PDF with multiple sections to complete. Always download the current version from UCLA's medical records page, since the live PDF has carried inconsistent revision markings across its two pages.
Patient Information: full legal name, Medical Record Number (MRN), date of birth, and current address, phone, and email
Healthcare Facility: UCLA Health Hospitals/Clinics (specify doctor or clinic), Jules Stein Eye Institute, Resnick Neuropsychiatric Hospital, Arthur Ashe Student Wellness Center, or Counseling and Psychological Services (CAPS)
Records Release Destination: recipient name (hospital, clinic, person, or law firm), mailing address, phone and fax, and an email address for request-status updates
Delivery Format Selection: CD (the form's default when the field is blank), email (not used for neuropsychiatric and behavioral health records), or paper copy
Record Types Requested:
Clinic visits (office notes and consultations)
Emergency reports and discharge summaries
Laboratory, pathology, and operative reports
Radiology reports and images
History and physical exams, and billing statements
Mental health records (requires explicit authorization)
Avoiding Common Form-Related Delays
The errors that most often send a request back:
Missing signatures: Signature and date are both required, and UCLA does not accept electronic signatures on the downloadable form
Incomplete date ranges: Specify exact FROM and TO dates in MM/DD/YYYY format
Unchecked sensitive information boxes: Drug and alcohol abuse results, HIV/AIDS results, genetic testing, and psychological test results need explicit checkbox authorization when requested
Wrong facility specification: A general request won't retrieve specialty records
One point worth knowing: if the expiration field is blank, UCLA's current form defaults to 12 months after the signature date, so a blank expiration doesn't by itself make the authorization incomplete. Using UCLA's current form reduces the risk of omitting UCLA-specific information.
Codes Health validates every authorization before submission, checking date ranges, facility information, and provider-specific requirements.
HIPAA Authorization: Essential for UCLA Health Record Releases
Understanding HIPAA Regulations at UCLA Health
For a typical patient-authorized release to a law firm or other third party, the authorization has to satisfy HIPAA requirements under 45 CFR § 164.508:
Clear identification of the information to be disclosed
Identification of the person or entity authorized to receive it
Description of the purpose of the disclosure
An expiration date or event
Patient signature and date
HIPAA also permits certain disclosures without a patient authorization in circumstances the Privacy Rule defines, so not every release runs through § 164.508. Patients may revoke an authorization in writing through UCLA Health HIMS.
Who Can Authorize a Release?
A valid authorization can come from:
The patient directly
A personal representative whose currently effective legal authority covers the relevant healthcare decisions or record access
A parent or guardian who is the minor's legally recognized personal representative, subject to exceptions
A generic financial power of attorney does not automatically confer HIPAA access rights; the document has to grant healthcare authority and be effective under applicable law.
Records may also be obtainable through judicial process, such as a court order or qualifying subpoena, subject to HIPAA's judicial proceedings provisions and state law. That route is separate from a patient-signed authorization and doesn't make the attorney a personal representative.
When someone other than the patient signs, UCLA requires documentation of that person's legal authority, such as an Advance Directive or Power of Attorney. A law firm named as recipient does not become the personal representative merely by receiving records. Codes Health manages authorization workflows end to end while respecting each system's signature rules, including UCLA's position on electronic signatures.
Direct Contact Details for UCLA Health Medical Records Department
UCLA routes record types to different departments, and the wrong contact delays everything.
Main HIMS Department (General Medical Records)
Primary Contact:
Address: UCLA HIMS, Release of Information, 10833 Le Conte Ave, CHS BH-902, Los Angeles, CA 90095-1776
Phone: (310) 825-6021
Fax: (310) 983-1468
Email: ROI@mednet.ucla.edu
Hours: Monday through Friday, 8:00 AM to 4:30 PM Pacific Time
Specialized Department Contacts
Mental Health Records (Resnick Neuropsychiatric Hospital):
Phone: (310) 206-8182 per UCLA's Resnick records page; Form #30910 also lists (310) 267-2661 and (310) 794-1530
Fax: (310) 206-7682
Email: NPHROI@mednet.ucla.edu, for submitting the authorization
Mailing address: 10833 Le Conte Avenue, BH-239A, Los Angeles, CA 90095-7058 (Release of Information desk: 100 Stein Medical Plaza, Room BH-239A)
Note: Resnick accepts authorizations by email, but the form states that neuropsychiatric and behavioral health records aren't delivered by email
Radiology Imaging (Westwood):
Phone: (310) 825-6425
Fax: (310) 825-3205
Address: 200 Medical Plaza, B1-Level, Suite B165-11, Los Angeles, CA 90095
Radiology Imaging (Santa Monica):
Phone: (424) 259-8111
Hospital Billing:
Phone: (310) 825-8021
Outpatient/Physician Billing:
Phone: (310) 301-8860
Dental Records:
Phone: (310) 825-3195
Note: Not processed through main HIMS
STAT Requests (Physicians and Hospitals Only):
Urgent Fax: (310) 206-4831
Note: Urgent physician-to-physician or hospital transfers only
When to Call vs. When to Mail
UCLA accepts requests through myUCLAhealth, its secure online authorization, email, fax, and mail, and publishes no comparative processing speed for any of them. Provide an email address where the form asks for one, since that's where UCLA sends request-status communications. UCLA also says it will not fax copies of records to a home or business fax, so don't plan on a return fax for delivery.
Codes Health manages outreach across calls, faxes, emails, and portals until records arrive. Firms see completed outreach and the next required action rather than waiting on periodic vendor updates.
Accessing Your UCLA Health Medical Records Online (MyChart and Portals)
Setting Up Your UCLA Health MyChart Account
The myUCLAhealth patient portal is the quickest route for patients requesting their own records. Sign-up uses identity verification, and two-step verification is supported. UCLA publishes no separate, faster processing guarantee for portal requests; its figure is 15 business days of receipt.
Self-Service Record Access (No Authorization Needed): visit history and appointment summaries, laboratory results and radiology reports, medications, immunizations, allergies, discharge summaries, progress notes, and billing statements.
Technical Support: (855) 364-7052 (24/7)
What Records are Available Through Online Portals?
myUCLAhealth provides access to portions of a patient's health information, including many test results and clinical records. Mental health records, certain sensitive information, and records requiring certification may not be available for download. UCLA also states that the record request function can only be accessed by PC, with mobile devices not currently supported.
For matters requiring a complete record set, firms shouldn't assume the documents visible in the portal represent every responsive record. Codes Health works through provider portals, including UCLA's, alongside traditional channels.
Requesting Older or Archival Medical Records from UCLA Health
Special Considerations for Older Records
PI cases often need records spanning years, and older records may sit in different systems or with different custodians, so confirm the right department before submitting. As of July 8, 2025, Ashe Center records moved onto UCLA Health's system, which changes where a request goes depending on when treatment occurred.
UCLA Health's Record Retention Guidelines
Ashe Center Records Transition:
Appointments on or after July 8, 2025: UCLA Health HIMS
Appointments before July 8, 2025: Arthur Ashe Student Health
Counseling and Psychological Services has separate instructions, so don't assume this split covers student mental health records
Arthur Ashe Student Health (Pre-July 8, 2025 Records):
Address: UCLA Arthur Ashe Student Health & Wellness Center, BOX 951703, 221 Westwood Plaza, Los Angeles, CA 90095-1703
Phone: (310) 825-4073, Option 6
Fax: (310) 206-8012
Email: ashemedicalrecords@ashe.ucla.edu
Fee: None for current and past students; $15 for third-party requests
Codes Health helps identify every potential source, which matters in cases with long medical histories or incomplete client recollection.
Medical Records Release Form Template for UCLA Health Requests
Customizing a Template for Specific Needs
Form #30910 is the authorization for downloadable paper requests, and firms can build workflow templates around it: pre-fill firm name, address, phone, and fax in the recipient section, include the record types PI cases usually need, and keep separate templates by case type with client instructions for the patient sections.
Where to Find Reliable Templates
Use the current form linked on the UCLA Health medical records page. UCLA also offers a secure online authorization and the myUCLAhealth route, so the paper form isn't the only mechanism available.
Ensuring Completeness: What to Do After Receiving Records from UCLA Health
Checking for Missing Dates or Visits
Receiving records is the first step, not the last. Common gaps:
Date ranges missing from within the requested period
Absent billing records when medical records are present
Missing radiology images when reports reference imaging
Incomplete specialist consultation notes
Missing emergency department records from initial treatment
How to Address Incomplete Records from UCLA Health
If records look incomplete, contact UCLA Health HIMS at (310) 825-6021, ready to name which dates, facilities, or record types are missing.
Codes Health checks delivered records against the original request and available patient history, resolving gaps with UCLA before returning the set. That verified completeness step helps firms judge whether a record set is genuinely complete.
UCLA Health Record Fees and No-Cost Exceptions
Fees depend on the legal basis and who is asking, so the two regimes shouldn't be blended.
Patients requesting their own UCLA records are told there is no fee. For patient access generally, California Health & Safety Code § 123110 permits a reasonable, cost-based fee with paper copies capped at $0.25 per page and microfilm at $0.50.
For attorney pre-litigation requests, California Evidence Code § 1158 sets its own cost provisions: $0.10 per standard page, $0.20 per microfilm page, clerical costs capped at $16 per hour in the circumstances it covers, postage, and certain third-party retrieval costs.
UCLA may invoice third-party requestors, but its FAQ directs them to its invoice payment system without publishing a fee schedule, so confirm charges with HIMS rather than assuming a rate. Payment goes to "UC REGENTS" through the online payment portal or by mail.
California also provides a limited no-charge right to relevant records for specified public-benefit claims or appeals, covering programs such as Medi-Cal, IHSS, CalWORKs, SSDI, SSI/SSP, CalFresh, and qualifying veterans benefits, subject to statutory conditions. One limitation matters here: the Medical Board of California states the provision doesn't apply where a private attorney is paying the costs of the claim or appeal pending its outcome, so it isn't automatic for law firm requests.
Why PI Firms Use Codes Health for UCLA Health Retrieval
UCLA splits records across HIMS, Resnick, radiology film libraries, dental, billing, ophthalmology, and Arthur Ashe, each with its own contact and rules, and most PI clients have treated elsewhere in LA too. Codes Health brings that into one managed workflow and works toward complete records in a couple of weeks.
AI validation before submission that flags missing signatures, dates of service, misspellings, and provider-specific requirements
Multi-channel follow-up by call, fax, email, and portal until records arrive
Completeness verification against the original request, covering medical, billing, and imaging records
Flat fee pricing with no surprises as a case grows
Native Filevine integration, announced July 2026, so teams submit requests, track status, message the retrieval team, and receive records and billing inside the Filevine project
Custom integrations with CRM platforms and other medical software for high-volume firms
Records come in through claims clearinghouses, custodian integrations, proprietary provider networks, patient portals, fax, email, and phone.
Speed claims deserve a closer look. Codes Health's position is that services advertising same-day retrieval often return only the records immediately available electronically, not the complete set. Filling the gaps then requires added client involvement, which Codes Health says frustrates clients and leads to churn. Its approach is complete records in weeks, not months.
On general AI tools: General AI platforms like ChatGPT aren't designed for litigation-grade medical record review and can't analyze records at the level PI cases demand. Codes Health's AI platform is purpose-built for this work, analyzing records with high precision and flagging potential breaches of care, pre-existing conditions, and documented future expenses for attorney review, with human verification behind every insight.
Codes Health's MIT-educated engineering team continuously builds out additional workflows and products, so the platform keeps evolving and becoming more comprehensive to meet the changing demands of modern legal practices.
The Bottom Line
Cedars-Sinai isn't slow so much as split. Records sit with the Health Information Department, images with the Imaging Center, substance use records behind their own consent form, and the fax number people find first serves imaging orders. Requests that respect those divisions come back on schedule; the ones that don't come back as corrections. Check the signature line, check which department owns what you're asking for, then check the delivery against the form. Firms carrying several Cedars-Sinai clients hand that checking to Codes Health, which runs it for a flat fee.
Frequently Asked Questions
How long does it take to get medical records from UCLA Health?
UCLA Health states that requests are processed within 15 business days of receipt, and publishes no faster window for myUCLAhealth requests. STAT requests, available to physicians and hospitals only, get priority handling. Unsigned or incomplete requests are returned unprocessed, which is why validating forms first matters.
Can I request medical records for a family member from UCLA Health?
Yes, with documentation of your legal authority. When someone other than the patient signs, UCLA requires proof such as a Power of Attorney, court-appointed guardianship, or Advance Directive designation. Parents or legal guardians can generally request a minor child's records when they are the legally recognized personal representative, subject to exceptions. A power of attorney has to cover healthcare decisions or record access.
Is there a fee to obtain medical records from UCLA Health?
Patients requesting their own records are told there is no fee. Other charges depend on the legal basis: attorney pre-litigation requests fall under California Evidence Code § 1158, while patient access is governed by Health & Safety Code § 123110. UCLA directs third-party requestors to its invoice payment system without publishing a universal fee schedule, so confirm charges before submitting.
What if I need my UCLA Health records urgently?
STAT requests are available only to physicians and hospitals with urgent medical needs, by fax to (310) 206-4831. For legal matters with approaching deadlines, call HIMS directly. If authorization delays persist, judicial process may be an alternative route, subject to HIPAA and state law.
How do I correct an error in my UCLA Health medical record?
Submit a written amendment request to UCLA Health HIMS naming the information you believe is incorrect and the correction you want. HIPAA generally requires action within 60 days, with one possible extension of up to 30 additional days when the rule's requirements are met. UCLA advises that amendment requests may take roughly 60 to 90 days.
Does UCLA Health offer different contact information for radiology images versus written reports?
Yes. Written radiology reports come through main HIMS, but the actual images (X-rays, MRIs, CTs) require contacting the Radiology Film Library directly: Westwood at (310) 825-6425, Santa Monica at (424) 259-8111. Ophthalmology images from Jules Stein Eye Institute require the Ophthalmology Call Center at (310) 825-5000.
