![]() This may include sharing your health information with: Your health care team needs access in order to plan and deliver your health care. Only those who need it to provide you with health care. Authorization to Release your Personal Health Information.If you would like some or all of your medical record to be sent outside the hospital to your insurance company, lawyer or another hospital, please complete the form below: When you submit the form you will be informed if a fee applies.Ĭan I send my medical record to others who may need it? The law allows the hospital to charge a fee to recover costs. How much will my medical information cost? Request for receipt of Diagnostic Testing Reports.Electromyogram, Electro diagnostic Laboratory (EMG).Patients seeking diagnostic test results from the Cancer Centre and/or the Renal Care Program should submit this form directly to their clinician.Įxamples of Testing (NOTE: must have occurred within last 30 days) You may submit the completed form to or Fax: 61 or direction to Health Information Services. To get a copy you must complete the form linked below. Some test results may not be stored in our Patient Care System (PCS) and those results will have to be released by the department directly (e.g. Health Information Services will provide a copy of your diagnostic tests that have been completed at KHSC within the last 30 days and only those that are identified below. blood work, Pulmonary Function Test, Imaging, etc.)? Request for Access to the Personal Health RecordĬan I get a copy of my most recent (within last 30 days) diagnostic reports (e.g.If you would like a copy of your medical record, please complete the form below and mail or fax it to the KHSC Release of Information Department or hand it in to the Medical Records Department on Kidd/Davis 1. 4125) Is there a form I need to fill out to access my health care information and where can I find it? The information about you contained in your medical record belongs to you. You have a right to access the information in your medical chart under the law, with some limited exceptions. In order to do so, please contact the Release of Information Department at Kingston Health Sciences Centre (KHSC) where they handle all requests for both hospital sites.Įmail: Diagnostic reports and medical records will only be released via mail or in person as arranged with Health Information Services (61 ext. How do I see or obtain a copy of my medical record? Personal health information includes information such as your name, date of birth, address, health history and records of your visits to the hospital and the care that you received during those visits. Your medical record contains your personal health information. We conduct audits and complete investigations to monitor and manage our privacy compliance. We also take steps to ensure that everyone who performs services for us protects your privacy and only uses your personal health information for authorized purposes. We take steps to protect your personal health information (PHI) from theft, loss and unauthorized access, copying, modification, use, disclosure and disposal. The Privacy Office ensures that the information contained in your medical record is protected.
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