Medical Secretaries

Medical Office Building | 275 Hospital Parkway | Main Floor Lobby | (408) 972-6655 | Fax: (408) 972-6677

• Disability
  • •  If you know you are going on disability we recommend that you fill out your paperwork in advance.
    • Before completing your State Disability forms we recommend that you visit the Employment Development Department’s Website to obtain detailed information about State Disability and to answer any questions that you might have.
    
    Our office will need:
    • A completed Authorization for Disclosure Form
    • A completed Disability Claim Form
    • A completed Verification of Treatment form from your physician
    
    You may either mail or fax the completed forms to our office. Once received, you will be notified upon completion, within 2-weeks.
    
    You can fax or mail to:
    Medical Secretaries
    Medical Office Building
    275 Hospital Parkway
    San Jose, Ca. 95119
    Fax: (408) 972-6677
    

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• Family Medical Leave Act (FMLA)
  • Under federal law, most employers must grant an eligible employee up to a total of 12 work weeks of unpaid leave during any 12-month period for one or more of the following reasons:
    • To care for an immediate family member (spouse, child, or parent) with a serious health condition; or
    • To take medical leave when the employee is unable to work because of a serious health condition.
    
    Our office will need:
    • A completed Authorization for Disclosure Form
    • A completed FMLA packet from your employer’s HR department (or contact us if you are unable to get FMLA forms from your employer)
    • A completed Verification of Treatment form from your physician
    
    You may either mail or fax the completed forms to our office. Once received, you will be notified upon completion, within 2-weeks.
    
    You can fax or mail to:
    Medical Secretaries
    Medical Office Building
    275 Hospital Parkway
    San Jose, Ca. 95119
    Fax: (408) 972-6677
    
    

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• Medical Record Copy Request
  • Did you know that Kaiser Permanente keeps your medical records electronically? This means that your personal care provider can easily access most of your important health information and tests without your chart.
    • If you�re a new member, we recommend that you discuss with your personal physician what pertinent records he or she may need to continue your care. It may not be necessary for all of your records to be transferred from your previous non-Kaiser Permanente physician. • New members should receive a Medical Record Number from Kaiser Permanente before completing an Authorization for Disclosure Form and transferring medical records. Call the Member Services Call Center if you need assistance with obtaining a medical record number at 1-800-464-4000.
    
    For obtaining copies of your Medical Records for your personal use or a third party, our office will need:
    • A completed Authorization for Disclosure Form
    • A completed AB610 Form
    • A copy of your or the patients Photo I.D.
    
    Please Note:
    • When completing the Authorization for Disclosure Form , be sure to indicate to whom the records are being released (even if this is yourself).
    • Please print and sign your completed Authorization for Disclosure Form and AB610 form.
    • There also may be fees applicable for medical record copies in the amount of $0.25 per page copied.
    • If you wish to review your medical record without obtaining copies, submit an Authorization for Disclosure Form and an AB610 Form .
    Once received, you will be contacted within 5-days to set-up an appointment with one of our staff.
    • For copies of your records, you may either mail or fax the completed forms to our office. Once received, you will be notified upon completion, within 2-weeks.
    
    

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• DMV
  • If you are filling out any DMV forms please see the following:
    • DMV Placards
         – Click here for instructions on accessing the form and for a sample of a completed form.
    • If you have any questions about the DMV Placard, or any other forms please visit the DMV Website.
    
    Along with the completed DMV forms our office will need:
    • A completed Authorization for Disclosure Form
    • A completed Patient Information Records Form
    
    You may either mail or fax the completed forms to our office. Once received, you will be contacted within 10-days to pick up or have your DMV placard forms mailed to you (based on your request), which you can then submit to the DMV.
    
    You can fax or mail to:
    Medical Secretaries
    Medical Office Building
    275 Hospital Parkway
    San Jose, Ca. 95119
    Fax: (408) 972-6677
    
    

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• All Other Requests
  • For all other requests:
    Please see our list of services provided by the Medical Secretaries Department.
    
    We will also need:
    • A completed Authorization for Disclosure Form
    • A completed Patient Information Records Form
    
    You can fax or mail to:
    Medical Secretaries
    Medical Office Building
    275 Hospital Parkway
    San Jose, Ca. 95119
    Fax: (408) 972-6677
    
    If you have any questions regarding our services, please call us at (408) 972-6655.
    
    **Please be aware that there maybe a fee associated with some of our services.
    
    Click here for our most current fee schedule.
    

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