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Request Medical Records


To receive medical records, you must complete and submit the DMC Authorization to Release Medical Information form
.



Release of Information

Access to Your Medical Record

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

Your medical record will be treated as confidential by the hospital staff. No one outside the hospital, except your referring physician, may be given a copy of your record without your written permission. Exceptions are as required by law, transfer of care or third party payor/insurance contract.

You have the right to have a family member and your own physician notified of your admission to the hospital.

 


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:

  1. Patient's full name and date of birth (list any other names the patient may have had).
  2. Specific information being requested (e.g. type of report/information and dates of service, etc.)
  3. Purpose for which the information may be disclosed.
  4. To whom the information is to be sent (name and address)
  5. Specify authorization’s expiration date if desired (see ROI form)
  6. 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
  7. Date of the signature.

 

SUBMITTING REQUESTS & RECEIVING RECORD COPIES

Requests for medical records may be mailed or faxed to the Release of Information Department. To obtain contact information, please click here. Records will be sent to you via the US Mail. Medical Emergencies will be faxed directly to a physician or medical facility. Our average turnaround time for processing requests for records that are on-site is 5-7 business days, off-site records 2-4 weeks.


SENSITIVE INFORMATION

Certain information requires a special authorization covering sensitive information. This includes psychiatric, drug and/or alcohol abuse, HIV/AIDS, and sexual abuse information. Authorizations for sensitive information must specifically refer to the information that is to be released.


FEES

There is a fee for copies of your medical record. Please call the medical records department for current fee information.


QUESTIONS

Should you have any questions regarding requests for medical record copies please contact the Release of Information Department.


Patient/Visitor Information Related Sites:

DMCHS Authorization to Release Medical Information Form. 
Your Medical Record
Important Phone Numbers



Requesting Copies of Medical Records


For medical records from:

Mail the authorization to:


DMC Children's Hospital of Michigan

Medical Records
3901 Beaubien Blvd
Detroit MI 48201
33-745-5356


DMC Detroit Receiving Hospital

Medical Records
4201 St. Antoine Blvd
Detroit MI 48201
313-745-2900


DMC Harper/Hutzel Hospitals

Medical Records
3990 John R.
Detroit MI 48201
313-745-8022


DMC Huron Valley-Sinai Hospital

Medical Records
1 William Carls Drive
Commerce, MI 48382
248-937-3365


DMC Surgery Hospital

Medical Records
30671 Stephenson Hwy
Madison Hts, MI 48071
248-733-2352


DMC Rehabilitation Institute of Michigan

Medical Records
261 Mack Ave
Detroit, MI 48201
313-745-9831


DMC Sinai-Grace Hospital

Medical Records
6071 W. Outer Drive
Detroit MI 48235
313-966-3156


If you need a copy of your medical records, Download, print and complete the authorization form. 


Complete all areas. Be sure to specify the dates of service and type of information needed (i.e., ER report from 6/10/03 visit).


Place the completed authorization form in an envelope and mail to Medical Records at the appropriate address listed above.


If you are requesting records sent to you directly and not your physician you will receive a bill. If you have any questions, do not hesitate to call us. To obtain contact information, please
click here.



Obtaining/Completing Birth Certificates

 
DMC does not provide copies of birth certificates. Birth certificates created by the hospital are forwarded to the City of Detroit Department of Health and Wellness Promotion, Vital Records Division, office where they are recorded and permanent copies are retained. Birth certificates are created and registered for all infants delivered in the hospital or brought to the hospital immediately following birth. For information about how to obtain a copy of a birth certificate, please call (313) 876-4134.

Other Related Web Sites:
City of Detroit
Oakland County Birth Records -
For babies born at Huron Valley Hospital only

Completing Your Baby's Birth Certificate
Your baby's birth certificate is a very important legal document. It is used to verify birth and is required on a number of different occasions. Birth certificates are created for infants delivered in the hospital or brought to the hospital immediately following birth. The Michigan Department of Public Health requires completion of a birth certificate within five days following birth. The completed certificate is submitted to the Wayne County Clerk's office. Before arrival at the hospital to deliver your baby it is helpful to be prepared to name the baby and to know the preferred spelling for the name selected. You may give the child any first, middle or last name desired.

Following delivery and transfer to the Mother Baby Unit, staff from birth records will visit and interview the parents to obtain the information that is needed to complete the birth certificate. The mother will be asked to verify the information on the typed birth certificate for completeness and accuracy and to sign the worksheet and the original typed birth certificate prior to leaving the hospital.

If you need to contact the City of Detroit Department of Health and Wellness Promotion, Vital Records Division, please call (313) 876-4134.


Affidavit of Parentage

Patient/Visitor Information Related Sites:
State of Michigan Department of Community Health



Obtaining Death Certificates

DMC does not provide copies of death certificates. For information about how to obtain a copy of a death certificate, please call The City of Detroit Vital Records Department at (313) 876-4134.

Patient Representative Form - This form is to be used when requesting records on a deceased patient.

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