You have the right to see your medical record at a time suitable for both you and the staff. Once discharged, you may request and obtain a copy of your record for a reasonable fee. You have the right to request the disclosures we made of medical information
about you.
Confidentiality of Care
You have the right to see your medical record at a time suitable for both you and the staff. Once discharged, you may request and obtain a copy of your record for a reasonable fee. You have the right to request the disclosures we made of medical information
about you.
Obtaining Copies of Medical Records
Records can be released to anyone that the patient authorizes (in writing) to receive such information. A valid authorization MUST contain the following information or the request will be returned:
Patient’s full name and date of birth (list any other names the patient may have had).
Specific information being requested (e.g. type of report/information and dates of service, etc.)
Purpose for which the information may be disclosed.
To whom the information is to be sent (name and address)
Specify authorization’s expiration date if desired (see ROI form)
The patient’s signature or a patient’s legal representative’s signature. Authorizations signed by a representative must contain a copy of the guardianship papers or power of attorney
Date of the signature.
For more information on requesting copies of medical records and to access the Authorization to Release Medical Information form, please visit www.dmc.org.
