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Medical Records

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To Request An Individual Patient’s Records for a Third Party:

Patients and Third Parties, please complete the Authorization for Release of Information form to request a copy of an individual’s medical records to be released to a third party individual or institution. Note: The individual patient whose records are being requested must sign this authorization.

Completed Michael’s House forms may be returned in person, fax, by mail or email to: 

Miasha Patterson – HIM Specialist/Privacy Officer
[email protected]
Michael’s House
ADMISSIONS: (760) 450-9001
Medical Records Office: 
(760) 320-3439      
(760) 459-6086
Medical Records Fax:
(760) 325-0188

Completed Michael’s House forms may be returned in person, fax, by mail or email to:

Miasha Patterson – HIM Specialist/Privacy Officer
[email protected]
Michael’s House
1910 S. Camino Real
Palm Springs, CA 92264
Medical Records Phone:
(760) 320-3439 
Medical Records Fax:
(760) 325-0188

Consent/Authorization to Use or Release Protected Health Information (PHI)

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