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Patient request for medical records

Emanate Health has partnered with Sharecare Health Data Services to fulfill your request for records. The forms below are for patients requesting a copy of their own medical records, or legal guardians or patient representatives with a power of attorney.

If you are a provider, law office or you are requesting the medical records of someone other than yourself and are not the legal guardian, please visit the 3rd Party Medical Records Request page.

Begin the request process:

  • Click on the facility type and then the facility name below where you received your 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 such as a birth certificate or power of attorney document.
  • 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” if you are requesting records from a location not listed above.