Your request will be processed within 30 days.įor fees and payment information, see our Fees for Medical Records page. Mail them to Children's Mercy Health Information Management - 2401 Gillham Road, Kansas City, MO 64108. If you are a parent of a patient over the age of 18: You will need to include a copy of legal documentation stating that you are the court appointed guardian of the patient. If you are a patient over the age of 18: You will need to include a copy of a signed form of identification (like a driver's license or school ID) with the authorization. If you want another organization to send medical records to Children's Mercy, use the following forms:Īuthorization for release of medical information by an outside facility (PDF)Īutorización para la liberación de información médica (PDF)Ĭalling (816) 234-3455 to have a form sent by email, fax, or mail. If you want Children's Mercy to send medical records to another organization, use the following forms:Īuthorization for release of medical information by Children's Mercy (PDF)Īutorización para la divulgación de información médica por Children's Mercy (PDF)Īuthorization for release of behavioral health information (PDF)Īutorización para la liberación de información de salud conductual (PDF) Picking one up in person or using the links below. Fill out the Authorization for Release of Information.All charges are listed on our Fees for Medical Records page. There is a charge for receiving a complete medical record. Pertinent documentation includes most recent documentation pertaining to doctors' diagnoses, progress notes, test results, history and physical, consults, discharge summary and treatment. There is no charge for receiving pertinent information. If not, you may request this information by filling out an authorization form or contacting HIM by phone. If you have patient portal access, you may retrieve your child’s vaccination records there. This will help avoid the late-summer jam in the physician’s office and ensure important readiness is addressed well in advance. Request a copy of your child’s physical and/or vaccination records in early summer. Physical and Vaccination Records for School Enrollment To request medical records or pick up/drop off a medical record authorization in person, visit the following department: IMPORTANT: Be prepared to upload a copy of your Photo ID when using. Once a valid authorization is received, we will respond to your request within 30 days. Use our convenient online Medical Record Request form to submit your request more quickly. Authorizations must be dated within one year of receipt and are good for up to one year until completed. The authorization must be signed by the patient's legal guardian or the patient, if the patient is 18 years or older. Parents and legal guardians may request the release of their child’s medical information by filling out an authorization form (scroll down for links to these forms). Join the M圜hildrensMercy Patient Portal to stay connected with your child’s health care team and access personal medical information anytime online. You may also request a copy of a birth certificate by following these instructions.The Children’s Mercy Health Information Management (HIM) department maintains medical records for our patients. Medical records will often be transferred to another provider at no cost but in some instances there will be fees to cover the cost of providing copies. No doubt youre familiar with it by now as the The Health Insurance Portability and Accountability Act. For physician office records, please contact the office.įor records of care received at former Lake Health facilities (Lake Health diagnostic centers, Lake Health Physician Group offices, Lake West Medical Center, TriPoint Medical Center, Beachwood Medical Center, Madison Emergency Department, Chardon Urgent Care, Mentor Urgent Care, or Willowick Urgent Care), please choose this Authorization for Disclosure of Health Information form. HIPAA and the Right to Access Your Health Information It seems that HIPAA is brought up a lot in the media nowadays. To obtain a copy of your medical records from a University Hospitals inpatient facility or outpatient facility, please contact the facility. Download the Medical Records Release Form
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