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Medical Records Feedback

<!DOCTYPE html> <html xmlns="http://www.w3.org/1999/xhtml" class="no-js" lang="en-US"> <head> <meta charset="utf-8"/> <meta content="IE=edge" http-equiv="X-UA-Compatible"/> <meta content="initial-scale=1.0" name="viewport"/> <meta content="7MiYjX2ZghMOWvtKRWlar--c6mD2ose5EcbQFQ6szFA" name="google-site-verification"/> <title>Medical Records Feedback</title> <meta content="University of California, San Diego" name="ORGANIZATION"/> <meta content="index,follow,noarchive" name="robots"/> <meta content="Student-Health-Wellbeing-Admin" name="SITE"/> <meta content="Medical Records Feedback" name="PAGETITLE"/> <meta content="Medical Records Feedback" name="DESCRIPTION"/> <meta content="62da14770aaf69f57b25c9533ef8ab07" name="id"/> <link href="//cdn.ucsd.edu/cms/decorator-5/styles/bootstrap.min.css" rel="stylesheet"/> <link href="//cdn.ucsd.edu/cms/decorator-5/styles/base.min.css" rel="stylesheet"/> <!-- Site-specific CSS files --> <!-- Other CSS files --> <!--[if lt IE 9]> <link rel="stylesheet" href="https://cdn.ucsd.edu/cms/decorator-5/styles/ie-support.css" /> <![endif]--> <!-- Other JS files --> <script src="https://cdn.ucsd.edu/cms/decorator-5/scripts/modernizr.min.js"></script> <!-- Site-specific javascript files --> <!--[if lt IE 9]> <script src="https://cdn.ucsd.edu/cms/decorator-5/scripts/respond.min.js"></script> <link href="https://cdn.ucsd.edu/cms/decorator-5/scripts/cross-domain/respond-proxy.html" id="respond-proxy" rel="respond-proxy" /> <link href="/_resources/cross-domain/respond.proxy.gif" id="respond-redirect" rel="respond-redirect" /> <script src="/_resources/cross-domain/respond.proxy.js"></script> <![endif]--> </head> <body> <header class="layout-header"> <a class="sr-only skip-to-main" href="#main-content">Skip to main content</a> <div id="uc-emergency"></div> <!-- title section --> <section aria-label="Site Name" class="layout-title"> <div class="layout-container container"> <a class="title-header title-header-large" href="/"> Student Health &amp; Well-Being Administration </a> <a class="title-header title-header-short" href="/"> SHW Admin </a> <a class="title-logo" href="http://www.ucsd.edu">UC San Diego</a> </div> </section> </header> <div class="navmenu navmenu-default navmenu-fixed-left offcanvas" style=""> <ul class="nav navbar-nav navbar-right msearch"> <li> <div class="search"> <button aria-label="search" class="search-toggle btn-default"> <span class="glyphicon glyphicon-search"></span> <span class="caret"></span> </button> <div class="search-content" id="search-m"> <form action="/search/index.html" method="get"> <label for="search-scope" style="display:none;">Search</label> <select class="search-scope" id="search-scope-m" name="search-scope"> <option selected="selected" value="student-health-wellbeing-admin">This Site</option> <option value="default_collection">All UCSD Sites</option> <option value="faculty-staff">Faculty/Staff</option> </select> <div class="input-group"> <label for="q-m" style="display:none;">Search Term</label> <input autofocus="autofocus" class="form-control search-term" id="q-m" name="search-term-m" placeholder="Search..." type="search"/> </div> <input class="sr-only" type="submit" value="Submit"/> </form> </div> </div> </li> </ul> <button aria-controls="navbar" class="navbar-toggle sr-only" data-canvas="body" data-target=".navmenu" data-toggle="offcanvas" type="button">Close Nav</button> <ul class="nav navmenu-nav"> <li class="dropdown open "><a href="../about/index.html">About <span class="caret"></span> </a> <ul class="dropdown-menu navmenu-nav"> <li><a href="../about/contact.html">Contact Us</a></li> <li><a href="../about/administration-team.html">Administration and Business Operations</a></li> <li><a href="../about/shaa.html">Analytics and Assessment</a></li> <li><a href="../about/spir.html">Strategic Planning, Innovation and Research</a></li> </ul> </li> <li class="dropdown open "><a href="../uc-ship/index.html">UC SHIP <span class="caret"></span> </a> <ul class="dropdown-menu navmenu-nav"> <li><a href="../uc-ship/changes.html">Changes for 2024-2025</a></li> <li><a href="../uc-ship/use/index.html">How to Use UC SHIP</a></li> <li><a href="../uc-ship/outside-area.html">Medical Care Outside the UCSD Area</a></li> <li><a href="../uc-ship/mobile-app.html">Mobile App</a></li> <li><a href="../uc-ship/forms.html">Forms</a></li> <li><a href="../uc-ship/waive/index.html">Waiving UC SHIP</a></li> <li><a href="../uc-ship/faq.html">UC SHIP FAQ</a></li> <li><a href="../uc-ship/medical-assistance-fund.html">Medical Assistance Fund</a></li> <li><a href="../uc-ship/uc-ship-committee.html">UC SHIP Committee</a></li> <li><a href="../uc-ship/non-registered/index.html">UC SHIP for Non-registered Students and Dependents</a></li> <li><a href="../uc-ship/uc-campuses.html">Visitors From Other UC Campuses</a></li> <li><a href="../uc-ship/summer-success.html">Summer Success Programs</a></li> <li><a href="../uc-ship/billing.html">Billing</a></li> </ul> </li> <li class="dropdown open "><a href="../insurance-other/index.html">Insurance: Other <span class="caret"></span> </a> <ul class="dropdown-menu navmenu-nav"> <li><a href="../insurance-other/medi-cal.html">Medi-Cal Recipients</a></li> <li><a href="../insurance-other/raft/index.html">RAFT</a></li> <li><a href="../insurance-other/billing.html">Billing</a></li> <li><a href="../insurance-other/webinars.html">Health Fee and Insurance Webinars</a></li> <li><a href="../insurance-other/mystudentchart-ucsd-health.html">MyStudentChart and the UCSD Health System</a></li> </ul> </li> <li class=""><a href="../medical-records/index.html">Medical Records</a> </li> <li class="dropdown open active"><a href="index.html">Feedback <span class="caret"></span> </a> <ul class="dropdown-menu navmenu-nav"> <li><a href="insurance.html">Insurance Feedback</a></li> <li><a href="medical-records.html">Medical Records Feedback</a></li> <li><a href="sexual-misconduct.html">Report Sexual Misconduct</a></li> </ul> </li> <li class=""><a href="https://mystudentchart.ucsd.edu/">MyStudentChart Login</a> </li> <li class="dropdown open "><a href="https://studentwellbeing.ucsd.edu/">SHW Sites <span class="caret"></span> </a> <ul class="dropdown-menu navmenu-nav"> <li><a href="https://studenthealth.ucsd.edu/">Student Health Services</a></li> <li><a href="https://caps.ucsd.edu/">Counseling and Psychological Services</a></li> <li><a href="https://shwadmin.ucsd.edu">Student Health &amp; 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Well-Being Administration</a></li> <li><a href="https://healthpromotion.ucsd.edu/">Health Promotion Services</a></li> </ul> </li> </ul> <div class="btn-nav"></div> <ul class="nav navbar-nav navbar-right"> <li> <div class="search"> <button aria-label="search" class="search-toggle btn-default"> <span class="glyphicon glyphicon-search"></span> <span class="caret"></span> </button> <div class="search-content" id="search"> <form action="/search/index.html" id="cse-search-box" method="get"> <label class="sr-only" for="search-scope">Search Scope</label> <select class="search-scope" id="search-scope" name="search-scope"> <option selected="selected" value="student-health-wellbeing-admin">This Site</option> <option value="default_collection">All UCSD Sites</option> <option value="faculty-staff">Faculty/Staff</option> </select> <div class="input-group"> <label for="q" id="search-term-label" style="display:none;">Search Term</label> <input autofocus="autofocus" class="form-control search-term" id="q" name="search-term" placeholder="Search..." type="search"/> </div> <input class="sr-only" type="submit" value="Submit"/> </form> </div> </div> </li> </ul> </div><!--end nav collapse --> </div> </nav> <main class="layout-main" id="main-content"> <div class="container"> <div class="row"> <div class="container"> <div class="row"> <ol aria-label="Breadcrumb" class="breadcrumb breadcrumbs-list"> <li><a href="../index.html">HOME</a></li> <li><a href="index.html">Feedback</a></li> <li aria-current="page">Medical Records Feedback</li> </ol> </div> </div> </div> </div> <div class="container"> <div class="row"> <!-- display the main content --> <section aria-label="Main Content" class="col-xs-12 col-md-9 main-section pull-right"> <h1>Medical Records Feedback</h1> <p>We welcome your feedback! Please complete the form below. If you wish to remain anonymous, you can leave the name and email fields blank. If you include your contact information a member of the team will contact you within 7 business days to let you know that we have received your feedback and what the next steps are.</p> <div data-formheight="551" data-formurl="//eforms.ucsd.edu/embed.php?id=567241" data-paddingbottom="10" id="mf_placeholder"></div> <script>// <![CDATA[ (function(f,o,r,m){ r=f.createElement('script');r.async=1;r.src=o+'js/mf.js'; m=f.getElementById('mf_placeholder'); m.parentNode.insertBefore(r, m); })(document,'//eforms.ucsd.edu/'); // ]]></script> </section> <section aria-label="Sidebar" class="col-xs-12 col-md-3 sidebar-section" role="complementary"> <figure aria-label="Logo" id="site-logo" role="complementary"> <logo/> </figure> <article aria-label="Sidebar Nav" class="main-content-nav" role="navigation"> <h2> <a href="index.html">Feedback</a> </h2> <ul class="navbar-list"> <li class=""> <a href="insurance.html"> Insurance Feedback </a> </li> <li class="active"> Medical Records Feedback </li> <li class=""> <a href="sexual-misconduct.html"> Report Sexual Misconduct </a> </li> </ul> </article> <custom/> </section> </div> </div> </main> <footer class="footer"> <div class="container"> <div class="row"> <div class="col-sm-8"> <p> <span>UC San Diego 9500 Gilman Dr. La Jolla, CA 92093 (858) 534-2230</span> <br/> <span> Copyright 漏 <span class="footer-copyright-year">2025</span> Regents of the University of California. 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