First specify if you would like to pick up the copies in person (at your local clinic) or have us mail them to you. We encourage you to sign up for MCC Connect where you can safely receive an electronic copy of your records.
Print and complete the Authorization for Release of Health Information form, bring it with you to the Medical Records Department at your home clinic or you can mail it to the address below.
To expedite the process, you may email a scanned a completed and signed copy along with a copy of the patient’s valid photo ID to firstname.lastname@example.org OR fax the completed and signed form and a copy of the patient’s valid photo ID to Medical Records at 415-448-1568.
Note: Requests for medical/dental records are processed in the order they are received. Medical/dental records will be delivered within 14 calendar days upon receipt of request. If you have any questions regarding release of health information, please call 415-798-3124.
Mail the completed form to:
Marin Community Clinics
C/O HIMS Dept.
PO Box 5008
Novato, CA 94948