Harbor UCLA Medical Center Graduate Medical Education
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EHS Medical Record Release - for away rotations


Outside institutions often require proof that residents rotating to their facility have completed certain health screenings, like a PPD test.  Harbor's Employee Health Services can assist with these requests.  Here are instructions:

  1. Download Release Form
  2. Complete form and obtain trainee signature; include an explanation about why you are making the request, (i.e. Resident is rotating to Kaiser on 1/4/05 . . .)
  3. Fax (310-222-5326), mail (Box B451) or deliver to Employee Health (room B-03)

If you have questions, contact Employee Health at 310-222-2360.