How do I obtain my Health Record or Diagnostic Image?
If you were a patient of Southlake Regional Health Centre, you can receive a copy of your health records for personal, legal or insurance use by submitting a signed Access to Personal Health Information and Disclosure Consent Form
. This form allows us to release the records to you. Please note that you must provide photo I.D. to pick up your records. A basic search charge/s will apply (refer to table below).
What happens if I want my record or diagnostic image released to another individual?
Whether you want your records released to a relative or friend, you must submit a signed Access to Personal Health Information and Disclosure Consent Form
. This form allows us to release the records.
You must alsoprovide a written note, signed and dated, permitting that individual to pick up the records. The individual picking up the records on your behalf must show their photo I.D.
Access to Personal Health Information and Disclosure Consent Form
Will the hospital have all my records on file?
Health Information is responsible for the release of patient health information for the timelines required by law. Currently, we are responsible to keep patient records for 10 years. If the patient was a child, the records are kept for 10 years past the year the patient reaches their 18th birthday.
We also release diagnostic images on CD or film. By law we are required to keep the images for 5 years from the exam date. If the diagnostic image was of the breast then we mustretainit for 10 years. If the patient was a child the mentioned timelines apply once the patient has reached their 18th birthday.
Do I need parental consent if I am a youth?
If the patient is 15 years of age or younger, parental consent is required. If the patient is 16 years of age or older, they are capable of requesting their own records and can consent to disclosing their health information.
What happens if I am inquiring about records for a deceased patient?
To obtain records for individuals who are deceased, proof of executorships or legal signing authority must be submitted with the request. The Power of Attorney does not have the right to access records of a deceased patient.
How do I go about requesting birth/death/proof of hospitalization information?
If you are looking for birth/death/proof of hospitalization information (e.g. proof of birth/death, time of birth/death), submit a signed Access to Personal Health Information and Disclosure Consent Form
. This form allows us to release the records to you or another authorized individual of your choice (we need proper documents to release to another individual, their photo I.D. and a permission letter from you). Print and complete the form and bring it with you to request your records. You must provide photo I.D. to pick up your records.
I am an insurance company or lawyer requiring a patient's records for a claim.
The Release of Information team requires an original request from the requester stating what is needed. Included with the request must be an original signed consent of patient/client or substitute decision maker with the paperwork proving such.
We no longer require prepayment. Once we receive the request with all proper documentation, we invoice for the full amount. When the payment in full is received, the records are released.