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Palo Alto Medical Foundation - Serving communities around Palo Alto, Mountain View, San Jose, Fremont, Redwood City, Dublin, Sunnyvale and Santa Cruz
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    Health Information Management (HIM)

    For Patients in Castro Valley, Dublin, Fremont, Los Altos, Menlo Park, Palo Alto & Redwood City

    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 health care professionals such as doctors and nurses provide quality health care.

    The following information will help you get the most out of the HIM Department.

    Contact Information for PAMF Palo Alto Division Health Information Management

    Health Information Privacy (HIPAA) Hotline – 650-853-5375
    Medical Records Release – 650-853-4745
    Medical Records Release Fax – 650-853-6093

    Michal Williams, RHIA, HIM Director and Privacy Officer – 650-853-4859
    LeeAnn Schierburg, RHIA, HIM Manager – 650-853-6062

    Medical Records
    For questions about your medical records, please call 650-853-2963.

    To authorize disclosure of your confidential medical information, please print and fill out the Authorization for Use and Disclosure of Health Information Form (PDF, 80kb)

    Form is also in Spanish, Autorización para el uso y divulgación de historial médico. (PDF, 86kb)

    The release form requires a pre-payment of $12 per person or $24 per family.

    • Fee is $12 for first 150 pages, $.10/page for subsequent pages.
    • We accept cash, check or Visa/Mastercard.
    • Checks are payable to: "ACTA Medical Services, Inc.".
    Please include a check (made payable to ACTA Medical Services) with your authorization form. You can also pay with a credit card by calling 650-853-4745.

    Forms cannot be accepted by fax. Please mail your completed form to:

    ACTA
    Palo Alto Medical Center
    795 El Camino Real
    Palo Alto, CA 94301

    Your request will be processed and mailed to you in three to five business days.
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    serving communities around Dublin, Fremont, Monterey, Mountain View, San Francisco, San Jose, Santa Cruz, San Mateo & Oakland