How to Get Your Medical Records at City of Hope

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.

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

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

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 | Spanish.

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 Processing

For City of Hope Duarte/Lennar patients, your disability or medical forms should be submitted to our HIMS department for logging and tracking purposes. HIMS will serve as the liaison between you and your treating provider to facilitate timely completion. Please allow 10 business days for your request to be processed.

Note: For all other locations, please contact your care team for instructions on how to submit your disability or medical forms.

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: [email protected]
• 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