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Records Request

UCLA Psychology Clinic Records Request Procedure:

  1. Download the Authorization to Release Information Records Request Form at the following website:  https://ucla.box.com/s/6d3o7n8p9e81mlmlabon8a82jzgndcef
  2. Complete form and submit to: ucla@psychclinic.hush.com

A copy of the records requested will be sent in the preferred method of transmission as soon as possible.