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
HOW TO OBTAIN COPIES OF MEDICAL RECORDS AUTHORIZATION FOR RELEASE OF INFORMATION (ROI)
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.
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.
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.
There is a fee for copies of your medical record. Please call the medical records department for current fee information.
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 Childrens Hospital of Michigan
3901 Beaubien Blvd
Detroit MI 48201
DMC Detroit Receiving Hospital
4201 St. Antoine Blvd
Detroit MI 48201
DMC Harper/Hutzel Hospitals
3990 John R.
Detroit MI 48201
DMC Huron Valley-Sinai Hospital
1 William Carls Drive
Commerce, MI 48382
DMC Surgery Hospital
30671 Stephenson Hwy
Madison Hts, MI 48071
DMC Rehabilitation Institute of Michigan
261 Mack Ave
Detroit, MI 48201
DMC Sinai-Grace Hospital
6071 W. Outer Drive
Detroit MI 48235
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.