Medical Records Request

To request medical records (immunizations, etc.) for yourself or a child under 18 years of age for whom you are the legal guardian, download the Authorization for Use, Disclosure and/or Request of Protected Health Information in English or Spanish.

The form may be mailed or hand delivered to the following location:

Innercare – El Centro
Attn: Medical Records
852 E Danenberg Dr.
El Centro, CA 92243

Note: The form must be signed with an original signature, not signed electronically.