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Student Wellness Services  /  Resources  /  Request Medical Records

Request Medical Records

September 11, 2024

How to request records for health, counseling, and/or occupational therapy

Step 1:
Fill out the Release of Information and Records Consent Form (PDF).

Step 2:
Attach the form and send by either secure message through the Student Health Portal or an email to Karen Hernandez at henka@caltech.edu.

Manner of Release:
Records will be ready for release within 5-7 business days. Please indicate in your message how you would like your records to be released. Records may ONLY be released by in-person pickup, fax, or sent via postal service. You will be contacted by phone or email when they are ready to be released.

Fee Schedule for Copies of Records:

  • 1-3 pages: no charge
  • 4-10 pages: $5.00
  • 11-20 pages: $10.00
  • 21+ pages: $15.00 plus $0.35 per page
  • Records sent directly to a new provider: $0.00

Payment is only accepted by cash or check. You may also pay with an active bursar account.
Please Note: Records are only kept for up to 7 years from the date of degree conferred.

Hours
Mon - Fri
8:00 am - 5:00 pm
Contact
1239 Arden Rd.
Mail Code 1-8
Pasadena, California 91125
Fax(626) 585-1522