You can download a copy of the Medical Records Release form on the link below.
You must have the form notarized in order for DataSafe/VRC (Vital Records Control) to release copies of your medical records and the original form must be mailed to VRC (Vital Records Control).
Please contact VRC client services and they will provide the mailing address for the records release and assist with your request for records..
DataSafe/Vital Records Control
Client Services 650-875-3700
Reference Dr. Weiss account # 13007908
There will be a charge for provision of the record copies plus the certified mail cost. If you prefer to pick up a copy of your the medical records at one of the DataSafe/VRC facilities ,there will be no charge for mailing. You (the patient) must provide a photo ID. With this option, you (the patient) are not required to have the medical records release form notarized since one of our Client Services Representatives will check your photo ID.
Datasafe/Vital Records Control records release for JMW Updated 4/13/21 (pdf)
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