Medical Records Office

To receive copies of your medical record, you must complete an Authorization form: Authorization for ROI

Autorización Para Uso y Divulgación de Información de Salud

Bring In, Mail or fax your completed Authorization form to:

Mad River Community Hospital
Attn: Medical Records Office
3800 Janes Road
Arcata, CA 95521
Phone (707) 822-7220 ext. 4142
Fax (707) 822-2366

The Authorization form must be completed in order to be a valid Authorization, if mailing or faxing the form please include a copy of your Photo ID. Forms are good for 1 year. 

If you have any questions regarding obtaining copies of medical records, please contact the Medical Records Office at (707) 822-7220 ext 4142

Records Request
Birth certificates

Certified copies of Birth Certificates over 2 months old may be obtained from the Office of Vital Records located at 825 5th Street, Eureka, CA 95501. Vital Records shares an office with the County Clerk Recorder Office on the 5th floor of the Courthouse. Please call Vital Records at 707-445-7382 for fee information.

Notice of Privacy Practices

Mad River Community Hospital is committed to protecting your health information

.Privacy Practices

Patient Portal

Upon admission or discharge, you should receive a username and password to access your medical information. If you’re having trouble logging in, call (707) 825-4976 to reset your password. They will send you a new link to get started. Click on the link below to log in

The patient is our first concern. Our quest is to become California’s leading and most innovative community health center.


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