Obtain Your Medical Records

If you are receiving services and would like to request copies of your Medical Records please go to the Santa Barbara County Behavioral Wellness Clinic you are receiving services, and complete an electronic ROI Release of Information.

OR

A Release of Information Authorization/Request Form may be obtained at any Santa Barbara County Behavioral Wellness Clinic. Staff is available to assist with the completion of a paper ROI form.

The Clinic will forward the ROI to BWELL/HIM - Health Information Management    

If you are unable to make your request in person, Release of Information Authorization/Request forms may be obtained by to going to the Clients & Families Forms page on our website. Look for:

  • ROI - Consent for Release of Patient Information or Records English | Spanish and complete.

Fax completed ROI to: South County Services Santa Barbara # 805-681-5294 : North/West County Services Santa Maria/Lompoc # 805-737-7868.

Or

Mail to: Santa Barbara County Department of Behavioral Wellness

                 315 Camino Del Remedio, SB, CA 93110

                  Attn : BWELL HIM/ Medical Records.


Important Note: Incomplete information may delay processing.  Before submitting your request it is important to review the form for completion, including:

1) Personal identifying information of client, to include full name, date of birth and Social Security Number (last four digits are acceptable)
2) Name, address and phone number of the individual or organization to which you want records released
3) What the information will be used for/purpose
4) Description of requested information
5) Time period for the information being requested
6) Initials where required/(X or ✔ check marks are not acceptable)
7) Signature and date