Please complete the following form to request a copy of the audit trail for your medical record. The Audit Trail report provides a summary of personnel and providers who have accessed your record within the last six (6) months. The Audit Trail includes the name, role, department, and date of access.
Once a Patient Audit Trail Request has been received, Sansum Clinic's Release of Information (ROI) department will process the request and deliver the report in the format selected below.
If you have questions or concerns about an individual's access to your record, please contact Sansum Clinic's Compliance & Privacy Officer, Mara Sorkin at 805-681-1719 or msorkin@sansumclinic.org.