Request Imaging Records

Request your Imaging Studies

To request a copy of your imaging records, please fill out an Authorization for Release of Protected Health Information form.

• Authorization for Release of Protected Health Information - English
• Autorización para la divulgación de información de salud protegida - Español

You can either fax, mail, or take a picture of the form and email it to us as noted below:

• USPS Mail: Lompoc Valley Medical Center, HIM Department
  1515 E Ocean Ave, Lompoc, CA 93436
• Fax: 805-737-3386
• E-Mail: medicalrecords@lompocvmc.com

Facilities Requesting/Sending Imaging Studies for Continuation of Care

If you are requesting or sending studies via Ambra, LifeImage, or any other image exchange programs, please email: librarians@lompocvmc.com