Sun Clinical Laboratories

Authorization to Release Protected Health Information for Doctor Treatment Purposes

The protected health information available on our website encompasses data from January 1, 2022, onwards. For any lab reports or health information prior to 2022, please contact our customer service at 626-234-2355 and select option 1 for further assistance.

Please enter the exact full name and date of birth according to the patient's insurance card.

Patient Name (LastName, FirstName):

Patient's Date of Birth:

I HEREBY REQUEST Sun Clinical Laboratories to release Lab Report from the medical records of the patient named above, limited to the purpose of Medical Treatment.

Please note that this authorization is limited strictly to doctor treatment purposes and does not allow for the release of information beyond the scope necessary for treatment decisions.

Sun Clinical Laboratories

Authorization to Release Protected Health Information for Doctor Treatment Purposes

Patient Information