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  • Uh-4948 Breleaseb Of Patient - University Bhospitalb

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150 Bergen Street, B417 Newark, NJ 07103 Health Information Management Phone: (973) 9725604 AUTHORIZATION FOR RELEASE OF PATIENT RECORDS Please PRINT (except signature) and provide complete information.

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Most states, including Ohio, do not have specific laws mandating the minimum record retention period for patient medical records. However, HIPAA and the Ohio Medicaid rules mandates the retention of records for a period of at least six (6) years after payment of the claim to the provider.

University Hospital is a 519-bed academic medical center with an active medical staff of more than 785. We are home to northern New Jersey's Level I Trauma Center and we are a regional resource for advanced care in a wide range of medical specialties.

UH Personal Health Record For issues and questions related to your online person health record (MyUHCare), please call 1-833-222-0035 Monday – Friday: 8 a.m. – 8 p.m. You can also fill out our online contact form.

On September 30, 2023, all of your health care services with University Hospitals will be available in MyChart. FollowMyHealth for University Hospitals will be discontinued and your information will be transferred to MyChart.

Download a patient access form or request one by fax. Fax your completed form to (614) 533-1155. Healthcare providers can order records through a faxed request. The request must contain the patient's demographics and necessary information, such as test results, notes and discharge summaries.

University Hospital is an independent, standalone medical center owned by the State of New Jersey and governed by a board headed by Tanya Freeman, Esq. It is located in the University Heights section of Newark, New Jersey.

Email: irrecordrelease@ccf.org. Fax: 772.563. 4441.

(E) Each HCF shall have policies and procedures to ensure the confidentiality of patient medical records. (F) Each HCF shall maintain medical records as necessary to verify the information and reports required by statute or regulation for at least six years from the date of discharge.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232