VA Palo Alto Health Care System
Release of Information
![Employee handing form and clipboard to patient](https://webarchive.library.unt.edu/eot2008/20090114084021im_/http://www.palo-alto.med.va.gov/PALOALTO/images/roi100.jpg)
We can assist you with:
▪ access to your medical records
▪ obtaining copies of your medical records
▪ requests to amend your medical records
▪ completion of forms for benefits, insurance,
and other reasons
How to Request Information (by Mail)
To request a medical record, please print one of the forms listed in the column to the right, complete the requested information, sign the form, and mail it to the following address —
VA Palo Alto Health Care System
Release of Information (11MR)
3801 Miranda Ave
Palo Alto, CA 94304
Because forms must contain an original signature, e-mailed forms cannot be accepted.
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How to Request Information (Walk-Ins)
Facility |
Open |
Location |
Extension* |
Palo Alto |
Mon-Fri
8 AM - 4:30 PM |
Building 100
First Floor
Room A1-302
& A1-304 |
X66406
or x67298 |
Menlo Park |
Tues & Thurs
8 AM - 4:30 PM |
Building 334
Second Floor
Room A3-304 |
x22899 |
Livermore |
Mon-Fri
8 AM - 4:30 PM |
Trailer 34
Room 106 |
x35217 |
San Jose |
Mon, Weds, & Fri
8 AM - 4:30 PM |
Main Building
Room A304 |
x73554 |
*First dial the main number (650) 493-5000. Then enter the extension when prompted.
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Reviewed/Updated Date: January 16, 2007 |
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