Access to Your Medical Information 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.
To receive medical records, you must complete and submit the DMC Authorization to Release Medical Information. Download, print and complete the authorization form, DMC Authorization to Release Medical Information and Fees. Please Note: The second page contains the fees for obtaining medical records.
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 - or fax- to the Medical Records department of the hospital where care was given. Our Contact Information.
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.
Please Note: Address the envelope Attn: Medical Records
SAMPLE Detroit Medical Center Attn: Medical Records 6071 W. Outer Drive Detroit MI
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. Our Contact Information.
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:
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.
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.
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.
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.