Medical Records Request

The Desert Mountain Children’s Center maintains medical records in a secure manner and are only released only with a completed authorization form and only to:
  1. A client requesting their behavioral health medical records; or
  2. A recognized entity with a legal right to review the contents.
Requests for medical records that are not appropriately signed and/or filled out completely will not be processed. A fee may be applied to a specific request but will be communicated with the requestor prior to charging. Minor children between the ages of 12 and 17 may need to sign their own authorization. A designated staff member will review the records request and determine if the medical record, part of the medical record, and/or a treatment summary can be released. If you have any questions, please contact our office at (760) 955-3601.

Medical Records Request 

Instructions on How to Complete and Submit the Medical Records Request Form

**Clients 12 years and older may need to sign a release of information to process this requests for medical records**

  1. Fill in the Required Information: Complete all necessary fields in the form. To avoid any delays or errors in processing the medical records requests, ensures all information provided is accurate and up to date
  2. Save Your Progress: If you need to save your progress and return to complete the form later, select the "Save Progress" option in the top right corner, and you will receive the medical records request form via email to resume where you left off. 
  3. Submit the Form: Once all the required fields on the forms are filled in, verify that the email address is correct, click on the “Click to Sign” button at the bottom of the form.
  4. Confirming Email Address:  Records request forms will not be submitted if the referring party's email address is not confirmed. An email from Adobe Acrobat Sign will be sent to the referring party's email address.  Click on the "Confirm my email address" link provided in the email. The confirmation request will come from Adobe Acrobat Sign. Once you confirm your email address, you will be able to complete the records request.
  5. Confirmation Receipt: Requestors that submit a medical records request will receive an email from CAHELP via Adobe Acrobat Sign containing a completed PDF copy and printable version of the records request. If you choose to open the agreement via the link provided, it will take you to a web page of the completed records request. (NOTE: You will have to download the PDF if you choose this function.) There is no need to forward a copy of the confirmation to the DMCC. This copy is for your records.
  6. Printing the Form: Please note that the records request form cannot be printed while completing the form online, the completed PDF attached to the confirmation email may be printed. 

If you are experiencing any issues, please contact our office at (760) 955-3601 or by e-mail at [email protected].