Request Records

Below are the links to the portal for medical records and FMLA forms.

Patient Online Access Form

This is exclusively for patients and legal guardians with legal paperwork requesting a copy of their medical records.

Click here

Requester Submission Portal

This option is for healthcare providers, attorneys or if you are requesting the medical records of someone other than yourself and are not the legal guardian.

Click here

Online Patient Request Tool

Release of Health Information

Coastal Health has partnered with Sharecare to fulfill your requests for records.

Coastal Health is committed to protecting your medical information. For information about your rights and your obligations regarding the use and disclosure of your medical information, please see our Notice of Privacy Practices.

If you are our patient and would like to request your medical records, please click on the link below to complete your request for medical records. You must provide a valid email address and a government-issued ID.

  • Click here
  • to submit a request for medical records

If you cannot download and complete the paper form below. The authorization form must be legible and complete. Authorizations that are illegible or incomplete will be returned. Please note that records processing is faster using the online form above.

Records are usually available within 5-7 days from the time the request is received. If you are picking up your medical records in person, please be sure to bring a government-issued ID.

Only the patient, parent/legal guardian, or the patient’s legal health care representative can sign the form to release medical records. If you request records on behalf of the patient or as the patient’s representative, please provide a copy of an Advance Directive/Durable Power of Attorney for healthcare/ Conservatorship.

If you are an attorney, insurance company, or any other entity requesting records from our facility, please click on the link below to upload your request and the patient’s authorization.

  • Click here
  • to submit a request for medical records


When will my online medical record request be ready?

Your records will be ready in 5-7 business days from the receipt of your electronic request.

How do I check the status of my medical records request?

Go to:

How do I pay for my records?

Go to:

How do I contact Customer Service?

You may call: 858-244-1811 or contact support for live chat: