VitalChart® Virtual ROI Portal | Palomar Health Medical Records

Patient Information

Patient First Name

Patient Last Name

Other Patient Names (Optional)

Patient Date of Birth

Physician/Clinic (Optional)

Please select the visits/admissions you would like released:

Most recentAllIn a date range

Please select the type of information you would like released:

Medical Records

Purpose of Request

Please enter your reason for requesting records.Purpose:Limitations (Optional):

Your Information

Relationship to Patient

Name

Preferred Notification Method

Phone Number

Type

Retype Phone Number

Email Address (Optional)

Delivery Information

Medical Records Delivery Options

Please choose from one of the below options for Medical Records. You can download them directly from the website. Any Image CD (Radiology, etc..) will be delivered by mail via the US Postal Service to the address entered below.

Desired Delivery Option:

Recipient

Name

Address

Address Line 2

City

State

Zip

Phone or Fax Number

Delivery Summary

Medical records will be delivered via this website in Adobe PDF format. A notification will be sent when the records are ready for download, and they will be available for 30 days.
Normal processing time is 5 business days from time of receipt.
Please contact us if you have any questions.