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Contact Central Registration at (207) 907-1284 or ask your nurse. Phoenix, AZ 85013 1 to check the status of your request, make a payment or ask any questions. Should you require additional information, please contact our Release of Information Office within Health Information Management. Plain Language Summary of Financial Assistance, Authorization for Use or Disclosure of Health Information, Authorization for Disclosure of Patient Health Information, an individual whom you are their legal guardian. Book an appointment online for COVID-19 testing at one of our Assessment Centres. There is no longer an HIM/Medical Records department located at St. Jude Medical Center, CHOC at Mission, Mission Hospital Mission Viejo or Mission Hospital Laguna. 5940: AMITA Health Saint Joseph Medical Center Joliet: ATTN: Health Information Management AMITA Health Saint Joseph Medical Center Joliet 333 N. Madison St. Joliet, IL 60435 815.741.7593 On occasion, extenuating circumstances applicable to certain requests may delay the turn around time. You may be able to schedule a virtual visit with your provider. St. Joseph Healthcare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Requesting records via fax/mail Large requests may require additional time and are processed by the hospital’s contracted vendor. You will be contacted if you have submitted a request for records that cannot be fulfilled because the retention period has expired. Copies of your medical record can be faxed to healthcare providers for continuity of care. If you are requesting a copy of your own medical records, please complete the Patient Request for Medical Records Form (PDF, 213KB).. Birth/Death Records St. Anne Hospital. Once the records are ready, you will be notified via mail. Bangor, ME 04402-0403, Risk Management Department: 207-907-1881 All consultations are confidential and strictly advisory. You can also access and download a portion of your health information from your latest inpatient hospital stay on-line through the FollowMyHealth patient portal. If you have any concerns about patient care and safety in our hospital which we have not addressed, please contact the hospital’s management. How to request a copy of your medical record Hours of Operation: Monday to Friday 8:00 am to 4:00 pm. We ask that you provide certain information in order to assist us in providing the best healthcare possible: For a detailed description of your rights and responsibilities as a patient of St. Joseph Healthcare, click below, Patient Rights and Responsibilities (180k, pdf). Orange, CA  92686 Ascension Via Christi St. Joseph Hospital/Medical Center; Emergency Care; Address 3600 East Harry St Wichita, KS 67218 Phone 316-268-5000. Appointments. You will be offered information about Advance Directives before and after you are admitted. Due to State and Federal regulations, we will ask you if you have completed an Advance Directive and/or signed a Power of Attorney for healthcare matters. Fax Number: 416-530-6046 Paper or electronic abstract of pertinent documentation. St. Joseph's Health Information Management Department maintains all patient medical records. © Saint Joseph Health System • South Bend, Indiana, $0.10 per page ($0.08 per page for actual labor and $0.02 per page for supplies), plus applicable postage and sales tax not to exceed $50. We are located on the 4th floor of the hospital. It must to be completed, signed, and dated by the patient or the patient’s guardian/legal representative. Email: ROI@stjoestoronto.ca, Hours of Operation: Monday to Friday 8:00 am to 4:00 pm. An authorization form must be completed in order to obtain a copy of your medical record. If you have any questions please call 602.406.3350. Taking Charge of Your Health Care - From Maine DHHS. the most complete medical history possible, complete candor about your understanding of instructions regarding your healthcare, communication of your needs and wishes to our staff. 1100 W. Stewart Drive Regina Cleri Residence, Inc. (Boston, MA). I have an upcoming appointment with another healthcare provider and would like my medical records sent to that physician. All requests will be processed timely and appropriately. St. Joseph Medical Center, St. Clare, St. Francis, St. Elizabeth, St. Anthony Hospitals . Only pre-approved visitors can visit patients at our sites. At no cost to patients and their companions, interpreting Services are available either in person, phone or video interpreting. The authorization, Request for Release of Protected Health Information, can be downloaded and printed here. Indicate if Radiology/Imaging CDs are needed and date and type of image: Chest X-ray, CT, MRI. Patients must request their records in writing. In addition, POA documentation must be provided; a copy will be retained for hospital records. St. Joseph County Health Department | 574-235-9638- Marshall County Health Department | 574-935-8565. The medical record is a permanent document of the history and progress of every patient's medical care. If you are not satisfied for any reason, please speak immediately to your charge nurse. An Advance Directive is a legal document that specifies the care you would want, should you become unable to communicate those wishes to others. St. Joseph’s Health Centre Am I able to obtain a copy of my birth certificate? Frequently Asked Questions. Notice of Nondiscrimination and Accessibility Rights, Indicate the dates of treatment/admissions for which you are requesting information, Indicate the type of records needed, i.e. St. Joseph’s Health Centre Health Records Department 30 The Queensway Toronto, ON M6R 1B5. An authorization is not required, but can be completed. Toronto, ON According to the State of California’s Confidentiality of Medical Information Act, the hospital must receive a complete and properly executed Authorization before providing a copy of the patient’s records to anyone, including the patient. Exception: Radiology/Imaging CDs are available at the Radiology/Imaging Departments: St. Joseph Hospital, 1100 W. Stewart Dr., Orange You may download and print a copy using the link below: Authorization to Release Information Form Toll-free Outside Toronto: 1-800-461-2156 15080. To request copies of your medical records, please fill out our Authorization to Release Information Form. Is there a cost for obtaining copies of my medical record. Please note, records from another facility contained within the requested records may be released. Our priority is to ensure the safety and well-being of our patients and residents, and our people. In certain cases, a patient’s physician or psychologist may also be required to approve a request. Office of the Registrar General All sections of the form must be completed. Contact the IT Help Desk at 1265 for information. You can expect considerate and respectful treatment from us. St. Michael Medical Center. If you are requesting a copy of your own medical records to be sent to someone other than yourself, please complete the Authorization for Use or Disclosure of Health Information (PDF, 106KB). All medical records are protected by federal, state, and hospital privacy laws. St. Joseph Healthcare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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