This paper explains physicians’ acceptance, in terms of usage intentions, of one of the most relevant eHealth services or applications: Electronic Health Care Records (EHCR). For this purpose, the original structure of the Technology Acceptance Model (Davis et al. 1989: 985), which included perceived usefulness, perceived ease of use, attitude, and usage intention, is extended with trust and risk-related factors such as physicians’ perceptions of institutional trust, perceived risk, and information integrity. The results stress the special importance of cognitive instrumental processes (mainly, usefulness perceptions) and attitudinal dimensions (attitude towards usage and perceived institutional trust), as key determinants of physicians’ acceptance of EHCR systems. Perceptions of institutional trust exert strong direct effects on physicians’ perceived usefulness, perceived ease of use, and attitude towards the use of EHCR. Additionally, trust mediates the influence of perceived risk and information integrity perceptions on physicians’ acceptance of EHCR.