We Care About Your Health!
Request Your Medical Record
To request a copy of your medical record, please download and complete the "Authorization to Disclose Health Information" form. You may download the form by clicking the links below:
You may also pick up an authorization form from the Medical Records Department between the hours of 8:00am-3:30pm.
Submit Your Completed Form
Please submit your completed form along with a scanned, readable copy of a valid ID to:
- Fax: (559)-550-0371 OR (559)-479-4249
- Email: HIM@maderahospital.org
- US Mail: Attn: Health Information Management, 1250 E. Almond, Madera, CA 93637
For Questions
If you have any questions regarding your medical records, you can contact the following:
- Phone: (559)-675-5555 OR (559)-507-8525
Please note: The Medical Record Department does not have voicemail. If they are assisting other callers, the line may ring for an extended period of time or you may need to call again at a later time.
There is no cutoff date for obtaining your medical records. Someone will be available to assist you.