Tahoe Forest Hospital District

Medical Records

We keep a record of the services we provide for you. We will not disclose your record to others unless you direct us to do so or unless the law authorizes us to do so.

To Request Medical Records

To request your medical records please print both of the following forms. Forms may also be picked up in the Medical Records office.

English Forms

TFHD Authorization to Disclose Protected Health Information Form (English)

TFHD Special Consent to Disclose Protected Health Information Form (English)

Spanish Forms

TFHD Authorization to Disclose Protected Health Information Form (Spanish)

TFHD Special Consent to Disclose Protected Health Information Form (Spanish)

Written requests may also be made and Please complete and submit the following information:

• Patient Name
• Date of Birth
• Social Security Number
• Date of Service of records requested
• Specific use of this information (follow-up care, legal, personal)
• Date and Signature of patient

 

Please send forms or written requests via U.S. Mail, Hand Deliver, or via Fax (530) 582-1864.

Mail requests to:

Tahoe Forest Hospital District
Medical Records Department
10121 Pine Avenue
Truckee, CA 96161

Birth Certificates

Two years or under

To obtain from the Nevada County Recorder's Office (If born at TFHD) (530) 265-7264.

Two years or older

(530) 265-1221 ext 222

Social Security Numbers are issued at birth. It can take up to 10 weeks to receive a Social Security card for your newborn. If you have questions regarding a card please call (530) 885-5364.