How to Get Your Medical Records at City of Hope Los Angeles-Area Locations

City of Hope® recognizes your right to access, obtain a copy of or request to make a correction to your health information or medical records for City of Hope National Medical Center (City of Hope Cancer Center Duarte) and all other Los Angeles-area locations.

When you or your authorized representative or a third party (e.g., insurance company) request health information or medical records, we uphold strict guidelines adhering to state and federal privacy statutes when processing requests. All requests for health information or medical records are handled by our Health Information Management Services (HIMS) team.

Please be aware that City of Hope, by law, can only release information that you have specifically requested and authorized on your authorization form. If no specific direction was given, a Release of Information (ROI) specialist will reach out for clarification.

Ways to Request Your Health Information

Through Your Patient Portal

You or your authorized representative may request your medical records via the patient portal MyCityofHope. For information on how to enroll in the MyCityofHope portal, refer to the FAQ page on MyCityofHope.org.

By Walk-In Appointment

Walk-ins will only be permitted on the day of your scheduled appointment. Note: If you do not have a scheduled appointment, you will not be allowed to enter the facility.

Walk-In: City of Hope® Cancer Center Duarte

Go to 1500 East Duarte Road, Duarte, CA 91010. The HIMS correspondence office is near the social work department, office 1221B.
Hours of operation: Monday through Thursday (8 a.m. to 4 p.m.) and closed for lunch (noon to 1 p.m.)
626-218-2446

If the office is closed on the day of your scheduled appointment, you may leave your completed authorization form in the drop-off box next to the HIMS correspondence office.

Walk-In: City of Hope Orange County Lennar Foundation Cancer Center

Go to 1000 FivePoint, Irvine, CA 92618. The HIMS correspondence office is on the first floor, within the radiology department.
Hours of operation: Monday through Friday (8 a.m. to 4:30 p.m.) and closed for lunch (noon to 1 p.m.)
949-671-4275

For Other Los Angeles-Area Location Patients

Completed requests will be routed to our centralized HIMS department as appropriate.

By Phone

Requests may be initiated over the phone by calling 626-218-2446. An agent will provide the appropriate authorization forms to complete your request.

By Fax

Completed authorization forms may be faxed over to 626-218-8443.

By Email

Completed authorization forms may be emailed to himsroi@coh.org.

By Mail

Completed authorization forms may be mailed to:

Health Information Management Services (ROI)
City of Hope
1500 East Duarte Road
Duarte, CA 91010

Authorization Forms

If you have questions about the status of your request after submission, please call our centralized HIMS department at 626-218-2446. Please allow five working days to pass before requesting status.
Hours of operation: Monday through Friday (8:30 a.m. to 4:30 p.m.) 

Form to Authorize to Use and Disclose Your Protected Health Information

PHI authorization form in English
PHI authorization form in Spanish
What to Expect sheet in English

Form to Make a Correction to Your Health Information

If you find an error in your health information or medical records, you or your authorized representative must complete this Request for Amendment of Protected Health Information in English.

Form to Share Patient Portal Access

You or your authorized representative can securely and conveniently request your health information or medical records from your patient portal and they will be uploaded onto your or your designated proxy’s account).

You or your authorized representative (also known as a designated proxy) must fill out the Adult Proxy Authorization Form in English | Form in Spanish

Form to Access Your Child’s Patient Portal (MyCityofHope)

From the patient portal, the parent or legal guardian can securely and conveniently request health information or medical records and they will be uploaded onto the patient portal. 

The parent or legal guardian must complete the Pediatric Proxy Authorization Form in English | Form in Spanish

Form to Check Who Has Received Your Health Information

If you would like to request a list (also called an “accounting”) of who has received your health information or medical records, you or your authorized representative must complete the Request for an Accounting of Disclosures Form in English.

Note: Time frames that are requested may not exceed six years and releases made for treatment, payment and health care operations will not be included.

Disability Forms to Submit to Your Treating Provider

To begin the processing, your disability or medical forms must be submitted to our HIMS department. HIMS will work as the liaison between you and your treating provider. To prevent any delays of the processing of your forms, please do NOT submit them directly to your treating provider or treating provider care team. Please allow 10 business days for your request to be processed.

If you need resources to help, get you through treatment, you can download the Disability Benefits and Financial Resources for Patients and Families brochure in English | Spanish | Chinese.

1. Disability Paperwork

Please ensure all portions of your disability and medical forms that require your completion have been filled out prior to submitting them to HIMS.

2. Disability Forms

Forward your completed form(s) to HIMS through one of the methods listed below.

  • Email: dl-himsmedicalforms@coh.org
  • Fax: 626-218-8443
  • Mail:
    Health Information Management Services (ROI)
    City of Hope
    1500 East Duarte Road
    Duarte, CA 91010
  • Dropoff: The HIMS Office is located in the Geri & Richard Brawerman Ambulatory Care Center, office 1221B, near the lab and Social Work Department. 

    Hours of operation: Monday through Thursday (8 a.m. to 4 p.m.), closed for lunch from noon to 1 p.m. Note: During closed hours, you may still drop off your disability/medical form(s) at our drop-off box located outside the HIMS correspondence office.

3. Disability Documents

HIMS will work with your treating provider for completion. Note: Please allow 10 business days for your request to be processed.

4. Disability Documentation

Once your treating provider has completed your disability or medical forms request, HIMS will deliver your completed forms to the appropriate requester, as well as send a copy to you for your records.

Examples of Medical Forms City of Hope Cancer Center Duarte Can Help With
  • EDD State Disability (initial)
  • EDD State Disability (continuation)
  • EDD Paid Family Leave
  • Employer Paid Family Leave
  • Family and Medical Leave Act (FMLA)
  • Social Security "Neoplastic Disease"
  • Medical Certificate of Health Care Provider for Employee's Serious Health Condition
  • Attending Physician Statements (for insurance)
  • Restriction and Limitation (employer and school)
  • Authorization (Pre-Authorization for Oral Chemotherapy and Pain Management Medications)
  • Home Health Orders
  • Return to Work
  • Jury Duty
  • Medical Clearance (dental work)
  • DMV Handicap
  • Homeland Security
  • Insurance Claim Forms
  • Financial Assistance with Utilities
  • Questionnaires
  • The Leukemia & Lymphoma Society and Cancer-related Retreats
  • BCCTP (Breast and Cervical Cancer Treatment Program)
  • Medi-Cal or Medi-Cal Exemptions Forms