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Authorization for Release of Information from Medical Record 

Obtaining a copy of your University of California Irvine, Medical Center medical records is easy. To start your request, simply download, print, complete and sign the following authorization forms and fax or mail them back to us. Please be sure to sign the forms. Unsigned requests cannot be process.

• Authorization for Release of Health Information - English»
• Authorization for Release of Health Information – Spanish»
• Authorization for Release of Health Information – Vietnamese»

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Frequently Asked Questions »

Our fax number is 714.456.7576

Our mailing address is:

Medical Correspondence
UC Irvine Medical Center
101 The City Drive – Rt. 118
Orange, CA 92868 

Note: If you are a patient at the Anaheim or Santa Ana Family Health Centers, Gottschalk Medical Plaza, Surgery Laser Clinic or the Manchester Pavilion Orange, please contact that facility directly.

Your request will be processed and fulfilled within ten working days.  We will either mail records to the address specified on the authorization form, or you may pick up your copy from our office located at the address above between the hours of 8 a.m. and 4:30 p.m., Monday – Friday.

There is a $0.25 per page copying fee if the records are for your personal use. 

Should you wish to contact Medical Correspondence, please call 714.456.5670.