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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 for Medical Records via U.S. Mail, Hand Deliver, or via Fax (530) 582-1864.
For questions or inquiries, please contact the Medical Records Department at 530-582-3469.
Mail requests to:
Tahoe Forest Hospital District
Medical Records Department
10121 Pine Avenue
Truckee, CA 96161
Birth Certificates and Social Security Cards
Two years or under
Please contact the Nevada County Recorder's Office (530) 265-1221 to request a copy of your birth certificate.
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.
Incline Village and Nevada ONLY
DESTRUCTION OF HEALTH CARE RECORDS
Pursuant to Nevada Revised Statutes (NRS) 629.051:
- The health care record of a person who is less than 23 years of age may not be destroyed.
- The health care record of a person must be maintained for 5 years, after it has been received or created, unless federal law requires that it be retained for a longer period of time.
- The health care record of a person who has reached the age of 23 years may be destroyed after 5 years from the date the record was received or created, unless federal law requires that it be retained for a longer period of time.
