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3rd party request for medical records

Emanate Health has partnered with Sharecare Health Data Services to fulfill your request for records. The forms below are for providers, law offices or if you are requesting the medical records of someone other than yourself and are not the legal guardian.

If you are a patient requesting a copy of your own medical records, a legal guardian or a patient representative with a power of attorney, please visit the Patient Medical Records Request page.

Begin the request process:

  • Click on the facility type and then the facility name below where the patient received care. If the location is not listed, please select “Other Location.”
  • Fill out the form to request your records. Note: you will be asked to provide a copy of your ID as part of the process. You may also be asked to provide additional documentation.
  • You will receive an update or response from Sharecare within 3 business days.

Hospitals

Click the hospital name to view the request form

Medical Group Clinics

Click the facility name to view the request form

Covina

Glendora

San Dimas

West Covina

Other Location

Click “Other Location” if you are requesting records from a location not listed above.