How to Request Medical Records

Submit a request by email or fax.

• Download an Authorization for Release of Health Information form
• Complete, sign, and date the form
• Include a legible copy of a valid photo identification (driver’s license, military ID or state ID)
• Please note: If the form is not complete and/or your valid photo identification is not received, your request will be returned
• Submit the form and valid photo identification via fax or email
  • Email: MiraMesaTeam@AFCUrgentCare.com
  • Fax: Mira Mesa: 858-757-9177

Please allow us up to seven days to process your request, although we strive to process requests sooner. We will contact you if your request will be delayed or if we cannot fulfill your request.