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 How do I get a copy of my health records?
If you were a patient of the Kirkland and District Hospital,
you can receive a copy of your health records by submitting a written request to
the hospital. You can also download the Authorization for Disclosure of Medical Record
and fax it to the appropriate hospital's fax number (listed below).
Click here for an authorization form.
Click here for health records birth information.
What should the request include?
The written request for health records must include your
name, date of birth and mailing address as well as the type of information you need.
The request must be dated, witnessed and signed by one other person.
Will the hospital have all of my
records on file?
Kirkland and District Hospital retains and manages patient
records according to government legislation and the corporation by-laws. This means
the hospital may only maintain some of your records.
What happens if I want my records released to another individual?
Whether you want your records released to a relative, friend,
family doctor or another institution, you must submit a signed consent giving the
hospital authorization to release your information. The consent is valid for six
months and it must be dated and witnessed.
Do I need parental consent if I
am a youth?
Yes. If you want your health records released and you are
not at least 16 years old, you must have a parent or legal guardian submit the request
on your behalf.
What happens if I am inquiring about records for a deceased patient?
To obtain records for individuals who are deceased or incapable
of signing a consent, proof of executorship or legal signing authority must be submitted
with the request.
How do I go about requesting birth
information?
If you are looking for your birth information (e.g., proof
of birth, time of birth), please submit a written request that includes your mother's
full name at the time of your birth.
Does it cost me anything to request medical information?
There is an administrative cost for non-medical requests.
A pre-payment fee must be submitted with your written request. For further information,
download the fact sheet
for release of information fees.
For more information on Kirkland and District
Hospital release of information procedures and policies, contact Health Record Services:
Telephone: (705) 568-2217
Fax:
(705) 568-2103
The release of information
office is open Monday to Friday, 8:00 am to 4:00 pm.
Please Note: Health Record Services requires the original signed authorization form
in order to complete your request.
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