Records, forms, and certificates

Request and access medical information for yourself and your family

Visit my medical records to view and print your or your family members’ most commonly requested medical records and reports from Kaiser Permanente Northern California, including the following:

Allergies

Eyewear prescriptions

Health care reminders

Hospital stays & follow-ups

Immunizations

Ongoing health conditions

Past visit information

Questionnaires

Track my health

Test results

You can specify the date range, which medical records, and the party receiving the copy of your medical records. Allow 5 business days for the completion of your request. Note that Hospital and Medical Office records released as part of this request may contain references related to mental health, addiction medical conditions. Order an electronic copy of your detailed medical records.
A PDF summary of your online health records, including allergies, immunizations, ongoing health conditions, medications, test results, and some procedures. Additionally, it includes changing your physician or switching to another health plan. Download your health summary .
Whether you are extending an existing SDI claim or have just filed a claim for the very first time, we can assist your physician in completing your SDI certification of your medical disability to the SDI office. Request SDI medical certification .

If medically appropriate, a medical certification can be submitted to an employer to determine FMLA eligibility. Note: you will need a Work Status Report from your doctor to complete this request. If you do not yet have one, please email your doctor. You can do so in the Message Center.

Complete and submit this request to your doctor to certify your serious health condition(s). Your doctor will review your information to determine the appropriate timeframe requested for certification and may contact you for further information. Request FMLA medical certification.

ROMI can assist your doctor with completing an Attending Physician Statement for disability insurance or employer benefit submissions.

Before contacting ROMI, discuss your disability needs with your doctor. You'll need them to provide you with a work status report for the time you'll be off work. They may ask you to schedule an appointment with them.

Once your doctor has provided the work status report, contact us to request an Attending Physician Statement to submit to your insurer.

Contact the ROMI Department in your area if you have questions or need help.

If you need a doctor's note for a short-term absence (3 days or less) from work, school, or for other reasons, contact our Appointment and Advice Call Center at 1-866-454-8855.

Otherwise, ROMI will assist your doctor in completing the form. Reach out to us to submit your request. Generally, a physical assessment is required within the last 12 months.

Some of the common medical forms that we can assist with:

  • Health verification forms
  • School and camp entry
  • Sports clearance
  • DMV placard
  • Medical clearance forms
  • Utility baseline, like PG&E
  • Jury duty
  • Employer forms
  • Travel or accident Insurance medical certification forms
  • All other types of medical forms

ROMI doesn't need the hard (paper) copy of the form. We may substitute an equivalent electronic copy that meets the needs of your request.

The completed forms are returned to you by email to review and make a copy for your records before you give them to your school, employer, or other organization.

Contact the ROMI Department in your area if you have questions or need help.

ROMI can assist your doctor with completing a Physician Certification for Reasonable Accommodation Considerations under the Americans with Disabilities Act (ADA).

Before contacting ROMI, discuss your activity restrictions or impairments with your doctor and let them know that you need them to document a work and activity restriction form. They may ask you to schedule an appointment with them.

Once your doctor has documented your activity restrictions, contact us to request a Reasonable Accommodation Physician Certification.

Contact the ROMI Department in your area if you have questions or need help.
 

Get a list of immunizations for you or your child. You can download your official immunization certificate for use with school entry, camp, or for an employer. Print your immunizations here .

You can view and print your Kaiser Permanente pharmacy claims and copayment history for tax purposes at Medimpact.

You can also view additional information about your prescriptions online at kp.org pharmacy.

Access your billing records at kp.org costs and coverage.

In addition to the self-service option online, you can call our Member Services Contact Center or Patient Financial Services for assistance with the following requests.

Itemized statements or patient payment/copay requests: Member Services Contact Center: 1-800-464-4000

Secondary insurance and supplemental billing requests: Patient Financial Services HMO (KP Classics) Members: 1-800-498-2748
DHMO Members and Other Payors: 1-800-390-3507
 

Track your requests for Medical Records, Family Medical Leave Act (FMLA) Medical Certification, and State Disability Insurance (SDI) certification requests.

Release of Information unit locations

For a basic overview of your online health record, you may download your health summary. This is a summary only of your allergies, immunizations, ongoing health conditions, prescriptions, test results, and many (but not all) procedures. It meets most needs, including choosing a doctor outside of Kaiser Permanente or switching to another health plan.

You may also request your records and other documents by phone or by email, you can find your local Release of Medical Information department contact information here.

Central Valley area (Manteca/Modesto/Stockton)
(855) 208-7223
email: CVA-ROI-Department@kp.org

Diablo area (Antioch/Walnut Creek)
(925) 817-5661
email: DSAROMI@kp.org

East Bay area (Oakland/Richmond/Alameda)
(510) 752-6026
email: East-Bay-roi@kp.org

East Bay area (Pinole/Richmond)
(510) 307-2172
email: East-Bay-roi@kp.org

Fresno
(559) 448-4938
email: Fresno-ROI-Dept-Fax@kp.org

Southern Alameda County (Fremont/Hayward/San Leandro/Union City)
(510) 675-6700
email: GSAAROI-DEPT@kp.org

Napa/Solano area (Vacaville/Fairfield)
(707) 624-2366
email: VAC-ROI-Dept@kp.org

Napa/Solano area (Vallejo/Napa)
(707) 651-1359
email: VAL-ROI-Dept@kp.org

North Valley area (Sacramento/Roseville)
(916) 746-3646
email: NVLYROI@kp.org

Redwood City
(650) 299-3228
email: RWC-ROMI@kp.org

San Francisco
(415) 833-3778
email: SF-ROI-Department@kp.org

San Jose
(408) 284-5200
email: SJO-ROI@kp.org

San Rafael
(415) 492-6317
email: San-Rafael-ROI-Department@kp.org

Santa Clara
(408) 851-1750
email: Santa.Clara.ROI.Dept@kp.org

Santa Rosa
(707) 571-3770
email: SRO.ROI@kp.org

South Sacramento
(916) 525-6940
email: SSC-ROI-Dept@kp.org

South San Francisco
(650) 827-6409
email: SSF.ROI.Dept@kp.org