Medical Records

Health Information Management

Your privacy is very important to us. Community Memorial Health Information Management is responsible for securely maintaining and protecting our patients’ medical records. To comply with state and federal law, we may only release a copy of a medical record with proper authorization from the patient or a designated representative.

Obtain or View Your Medical Records

Complete the forms below:

• Authorization for Use or Disclosure of Health Information
  English | Spanish

• Psychotherapy Notes Authorization for Use or Disclosure of Health Information
  English | Spanish

Call Your Physician

You may also choose to have your physician call and request documentation necessary for an appointment ahead of time. This will ensure any necessary reports, results and/or documentation are available at the time of your visit. COVID-19 test results may be obtained by the physician who ordered the test.

Delivery Options

After your completed request has been processed, we will deliver the documents in the requested format and delivery mode. Please be advised that when utilizing email there is some level of risk that your health information could be read or otherwise accessed by a third party while in transit.

Please call us at 805-948-5047 for assistance with the following:

• Request current fee schedule

• Amend your medical record
  We will provide you with a “Request for Amendment of Protected Health Information” form. Complete and sign amendment form and return via mail, fax, or email. Requests take 7 – 14 business days to process. Unsigned or incomplete requests cannot be processed.

• Receive an "Accounting of Disclosures"
  We will provide you with an "Accounting of Disclosures" form. Complete and sign this form and return via mail, fax, or email. Requests take 7 – 14 business days to process. Unsigned or incomplete requests cannot be processed.

Submit Completed Forms

You may submit completed forms in the following ways. To protect your privacy and health information, we do not accept phone requests or disclose patient information over the phone.

Mailed Requests

Community Memorial Healthcare
Attn: Medical Records/ROI
147 N. Brent Street
Ventura, CA 93003

Faxed Requests

Community Memorial Medical Records
805-948-5649

Emailed Requests

Email your completed request in a PDF format to ROIrequests@mycmh.org

Contact Information

Phone: 805-948-5047
Hours: Monday – Friday, 8:00 am – 4:30 pm
Closed for the following Holidays:

• New Year’s Day
• Presidents Day
• Memorial Day
• Independence Day
• Labor Day
• Thanksgiving Day
• Christmas Day