Langley Porter Psychiatric Hospital & Clinics
Attn: Medical Records
University of California, San Francisco
401 Parnassus Avenue
San Francisco, CA 94143-0984
Phone: (415) 476-7776
Fax: (415) 476-7779
To request billing records, call: (415) 476-7183.
Three ways to request medical records
Request records online
You can submit an online request for medical records. Once they are ready, simply download the records. Submit a request online now for Langley Porter Psychiatric Hospital and Clinics.
Third party requests
If your insurance company, school, employer, or other third party needs information from your record, either verbally or written, such requests will require a valid written consent from you to release the information. To give this consent, complete the Authorization for Release of Medical and Mental Health Information Form and return to the address above.
It is preferable to let them request it directly as they can be more precise about what they need. The third party who has requested the information usually pays any charges for information furnished in this way.
Such requests will require a valid written consent from you to release the information.
All requests must include:
- Patient name and date of birth
- Name of person or agency to receive the information
- The specific information that is to be released
- Uses for which it is being released
- Any limitations you want to place on the release
- A date when the authorization will expire
- Your signature and date signed
Request by mail: Physical copies or access to view
All requests must be in writing; no telephone requests can be accepted. Your written request should be on the Langley Porter Request for Patient Access to Medical Record Form and returned to the above address or sent to the fax number above.