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ENDLESS MOUNTAINS HEALTH SYSTEMS EMHS 25 Grow Avenue Montrose, PA 188011106 Endless Care & Concern TSS 5702783801 Fax 5702784312 Phys. Office, 4827 Medical Records, 4973 ER endlesscare.org Authorization.

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Under 42 Pa. C.S. §§ 6152, 6152.1, and 6155 (relating to subpoena of records; limit on charges; and rights of patients), a health care provider or facility is allowed to charge a fee in response to a request for medical charts or records.

In most cases, you'll need to fill out a form and then make a request in writing. While it's possible your primary physician could have a complete version of your records, if you have seen multiple providers you may want to request a copy from each to ensure completeness.

Per UPMC Health Plan policy, all Medical records must be maintained for ten (10) years for adults and age of majority plus seven (7) years for children.

I would like to make an application to see my medical records under the Data Protection Act 1998 (living patients)/under the Access to Health Records Act 1990 (deceased patients)*. I wish to inspect the records made during the period (approximate date) to (approximate date).

How you make your request will depend on your provider's processes. You may be able to request your record through your provider's patient portal. You may have to fill out a form — called a health or medical record release form, or request for access—send an email, or mail or fax a letter to your provider.

In Pennsylvania, doctors must keep medical re- cords for seven years after the last treatment date. In the case of minor children, medical records must be kept for one year after the age of major- ity or for seven years, whichever is longer.

Upon the death of a patient, the hospital shall provide, upon request, to the executor of the decedent's estate or, in the absence of an executor, the next of kin responsible for the disposition of the remains, access to all medical records of the deceased patient.

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© Copyright 1997-2025
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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