Health Information Management (HIM)
For Patients in Cupertino, Los Gatos, Mountain View, Santa Clara and Sunnyvale
Health Information Management (HIM) is a vital component of the Palo Alto Medical Foundation (PAMF), health care system. We maintain, collect, and analyze patient health information to help PAMF health care professionals such as doctors and nurses provide quality health care.
HIM Contact Information for the Camino Division of the Palo Alto Medical Foundation
HIM Main Phone – 650-934-7979
Health Information Privacy (HIPAA) Hotline – 650-934-7990
Medical Records Release – 408-523-3267
Medical Records Release Fax – 408-524-5034
Cathy Brown, BA, RHIT, HIM Director and Privacy Officer - 650-934-7206
Rhoda Unanaowo, RHIT, HIM Manager - 408-523-3239
Sandra Madrigal, HIM Supervisor -408-524-5089
- Medical Records
- Help with Processing Disability Insurance Requests
- Help with Medical Records for Pediatric Patients
- Pediatric Forms Completion
- Health Information Privacy (HIPAA) Hotline
- Protected Health Information (PHI) Authorization
Medical Records
The Palo Alto Medical Foundation (PAMF) Records Department retains patient medical records for current and future physician reference. Your records are considered confidential and are not disclosed to any outside party without your written authorization.
To ensure the security of your personal health information, PAMF requires patients who need their records transferred to submit a Release of Information request to the Medical Records Patient Service Liaison, located at:
Mountain View Center
701 E. El Camino Real
Floor 2
Mountain View, CA 94040
To authorize disclosure of your confidential medical information, please print and fill out the Authorization for Use and Disclosure of Health Information Form (PDF file)
Form is also in Spanish, Autorización para el uso y divulgación de historial médico.
Cost is $12 per person or $24 per family for the last 3 years of records (maximum of 150 pages). For medical records older than 3 years or more than 150 pages in length, there is a charge of 10 cents per page. Please include a check for processing your request with your authorization form. You can pay with a credit card by calling (408) 523-3267.
ACTA Medical Services
c/o Palo Alto Medical Foundation
P.O. Box 61538
Sunnyvale, CA 94088-1538
Your request will be processed and mailed to you in three to five business days. Records will be sent to the requesting patient or health care provider by certified mailed at no extra cost.
There is no processing fee if you would like to have medical records from another health care provider transferred to PAMF. However, PAMF asks that you fill out a:
Copies of Radiology or Diagnostic Imaging Reports
Release of Information requests can be submitted to the Health Information Management Patient Service Liaison.
Mountain View Center
701 E. El Camino Real
Floor 2
Mountain View, CA 94040
Questions related to the release of Diagnostic Imaging records or images should be referred to the Diagnostic Imaging Services Mail Desk at 650-934-7757.
To obtain digital images on a CD, patients must complete two forms:
For diagnostic images and a release of medical information form
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Help with Processing Disability Insurance Requests
Disability forms are accepted by the HIM Patient Service Liaison (provide link) and processed by the PAMF HIM Disability Specialist. Blank Disability forms can be picked up at the Mountain View Center, listed above, or downloaded from the State of California EDD Web site.
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Help with Medical Records for Pediatric Patients
If a pediatric patient is scheduled for an appointment, the pediatrician or medical assistant will complete the form(s) at no charge.
All other forms will be processed by the HIM Patient Service Liaison. Processed forms will be mailed to the patient's residence, unless previous arrangements have been made to pick-up the forms in person. Payment for processing can be made by credit card or by check. Cash is not accepted.
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Pediatric Forms Completion
(School Forms, Camp Forms, Sports Forms, Daycare Forms)
Most schools, daycare centers, camps, sports and other organized activities for children require that a child be up-to-date on his or her vaccinations and be in good health. Our pediatric departments can help you fill out the health forms required in most enrollment packages. The following is some information to help guide you through this process.
- Forms may be completed at the well-child check-up at no charge. Other form requests will carry a nominal charge to help us cover the cost of providing this service outside of a medical exam.
- Please allow 10 working days for completion of your forms.
- When completion of the form requires that the child's paper medical record be retrieved and reviewed with needed information copied or summarized, a fee of $12 will be charged.
- If the form requires information about the child's physical condition (as opposed to a simple record of immunization), a Palo Alto Medical Foundation-Camino Division physician must have examined the child within the past two years.
- We can accept forms sent to us by mail or dropped off in person. However, we cannot accept faxed forms.
- Completed forms will be mailed to the parent, guardian or designee.
- Please pay the cashier or Release of Information coordinator and keep the receipt or form stamped "PAID."
- Forms may be mailed, with payment, to:
Palo Alto Medical Foundation-Camino Division
ATTN: HIM Medical Records
701 E. El Camino Real, M/S 31-306
Mountain View, CA 94040 - If you have questions regarding medical records, form completion or release of information, please call the Medical Records office at 650-934-7981.
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Health Information Privacy (HIPAA) Hotline
To discuss concerns about health information protected under the federal Health Information, Portability and Accountability Act (HIPAA) privacy provisions, please call the Health Information Privacy (HIPAA) Hotline at 650-934-7990.
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Protected Health Information (PHI) Authorization
If you would like to view your medical records, get a copy of them or grant authorization for someone else to do the following, then fill out this form:
Request for Access to Medical Information form
and submit it to the Health Information Management (HIM) Department.
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