For current and former patients seeking to verify medical records, including appointment history, a completed authorization for disclosure of health information form must be signed (e-signatures are not accepted) and submitted with a copy of a government-issued ID to the Health Information Management Office by fax at (213) 740-4961; the form and documentation (clear photo of the documents, or scans) may be also be submitted by email to email@example.com. Please select one of the two authorization of health information forms:
- to have records sent to you or
- to have records sent directly to third parties (i.e., other medical providers).
Understanding the Risk of Emailing PHI
I understand that there are risks associated with sending and receiving email with personal health information, including that email may not be secure and could leave my medical information open to viewing by an unauthorized third party. USC Student Health transmits medical records over its secure email system, which is designed to minimize the chances of an unintended recipient, but cannot guarantee that an email with my health information will not be intercepted or that a USC Student Health worker will not misaddress an email. If I am concerned about these risks, I should not select email as my delivery method. I understand that the secure email with my medical records will expire within 14 days and that I need to open the email, download and securely store my medical information promptly upon receipt. I will not be able to access the email or the medical record after 14 days.