You must attach legal documentation to verify that you are the Parent, Guardian, or Personal Representative of the individual.
Dates: you must specify dates to receive records.
Identification: to process your request, you must provide verification of address and identification; if no identification is attached, your signature must be notarized.
Date of death: if applicable, death certificate must be attached.
Delivery: any person or attorney may be named to receive a copy of the records, but records will not be sent to photocopy services.
| Question | Answer |
|---|---|
| Form Name | CDPH 6237 |
| Form Length | 4 pages |
| Fillable? | Yes |
| Fillable fields | 57 |
| Avg. time to fill out | 10 min |
| Edition | Rev 8/2026 |
| Issuing agency | California Department of Public Health |
| Other names | CDPH 6237, CDPH6237, CDPH 6237 form, Confidential Request to Access Personal Information, request to access personal information |
| Official source | CDPH 6237 (Rev 8/2026), California Department of Public Health |
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