Medical Records

The medical records of the USC Spine Center are maintained as an electronic medical record (EMR) by the Keck USC Hospital Information Services Department. The USC Spine Center strictly adheres to the USCUH Policy on Privacy Practices and HEALTH INSURANCE PORTABILITY and ACCOUNTABILITY ACT (HIPAA) Laws.

An Authorization to Use and Disclose Protected Health Information Form is used by an individual to consent to the release of his or her medical records/films to a new or different physician, to assist in a job application or when applying for certain insurance. A parent or legal guardian may also fill out an authorization to consent to the release records. An individual acting as an attorney in fact through a power of attorney may also use this form.

To protect the patient's privacy, the law permits disclosure of information only if the patient (or his or her legal representative) consents in writing or if the law otherwise permits it.

Obtaining an Authorization for Release of Information

Download Form:

By phone:
(323) 442-8778

By fax:
(323) 442-8520 (Attention: Health Information Management/Medical Records)

By mail:
Medical Records
Keck USC Hospital
1500 San Pablo Street
Los Angeles, CA 90033

After downloading the form and completing the information, please use the mailing address or fax to submit the request. The Center will make every attempt possible to fill medical record/film requests in a timely manner. However, if the requested records/films are in off-site storage, some medical record/film requests may take up to ten business days to process upon receipt.

Obtaining Authorization for the Release of X-Ray Films and Imaging Studies

In order to obtain the actual radiological studies (X-rays, MRI, CT Scan, Bone Scan films) done at Keck USC Hospital, you must contact the Keck USC Hospital Film Library.

Download Form:

By phone:
(323) 442-8955

By fax:
(323) 442-8803

By mail: Keck USC Hospital
Radiology, Film Library
1500 San Pablo Street, 2nd Floor
Los Angeles, CA 90033

The film library will loan films for 30 days, free of charge.

Copying Fees:

  • $19.00 per sheet
  • $152.00 MRI-full set
  • $92.00 CT-full set
  • Free CD (MRI and CT scans ONLY)