Request Medical Records

Convenient and Secure

Clients and legally authorized guardians can request copies of medical records through our secure online form. Submitting your request online is the fastest and most secure way to get started.

Prefer a paper form? Download the paper form in English (PDF) or Spanish (PDF).

What you’ll need

Please have the following information available, if applicable:

• Client’s full name and date of birth
• Medical record number or unique client identifier
• The records or reports you are requesting
• Date range for the records
• Person or organization that should receive the records
• Preferred delivery method
• Your name and relationship to the client
• Preferred email address for confirmation of your request

Please complete the request form as fully as possible so we can verify your request and release the correct information.

How the process works

1. Submit the secure online form. Tell us whose records you are requesting, what information you need, and where the records should be sent.
2. Look for confirmation. If you provide an email address, you will receive a confirmation email after submitting your request.
3. Provide additional information if needed. We will contact you directly if we need additional information or clarification to process your request.
4. Receive your records. Once all required information has been provided, requests are generally fulfilled within 15 days for California-based programs and 10 days for Hawaii-based programs.

What records can I request?

You may request specific medical records or reports, including:

• Assessments
• Treatment Plans
• Reports
• Other records identified in your request

You can request records for a specific date range.

Paper form options

If you prefer to submit your request by paper, you can download the appropriate form: English (PDF) or Spanish (PDF). Submitting your request online is still the fastest way to get started.

After completing the form, email it to [email protected].

You may also mail the completed form to:

Client Records
Catalight Care Services / ESNorCal / ESH
2730 Shadelands Drive
Walnut Creek, CA 94598

Are you requesting records for someone else?

If you are a personal representative, attorney, provider, school, insurer, or another third party, you will need to provide documentation showing that you are authorized to receive the client’s medical records.

Protecting your information

We review each request to help protect the client’s privacy and release only the information authorized in the request.

The authorization form identifies the client, the records to be disclosed, the recipient, the purpose of the disclosure, and the delivery method.

You may refuse to sign an authorization. You may also revoke an authorization in writing. A request cannot be processed until all required information and authorizations have been provided.

Delivery options

Depending on the request and available arrangements, records may be sent by:

• Encrypted email
• Pickup from the company
• U.S. mail

Questions or help with a request

For questions about a medical records request or to submit a completed paper authorization form:

Email: [email protected]
Phone: (855) 843-2476 or (925) 266-8500

Frequently Asked Questions

How long will my request take?

When all required information has been provided, requests are generally fulfilled within 15 days for California-based programs and 10 days for Hawaii-based programs. If additional information is needed, processing may be delayed until the missing information is received.

Will I receive confirmation that my request was submitted?

Yes. If you provide an email address on the online form, you will receive a confirmation email.

Can I request only part of my record?

Yes. You may request specific records or reports, and you can request records for a specific date range.

Can I request records for another person?

Yes, if you are legally authorized to do so or have the client’s authorization. We may ask for documentation confirming your authority to receive the records.

Can I use a paper form?

Yes. Paper forms are available in English and Spanish. See the Paper form options section above for the forms and instructions for submitting a completed request.

How will my records be delivered?

Available options may include U.S. mail, encrypted email, or pickup, where available. Select your preferred delivery method on the request form.

What if I need help completing the form?

Email [email protected] or call (855) 843-2476 or (925) 266-8500.