The releasor authorizes his/her employer to release employment references including, but limited to, his/her employment history and wages and any information which may be requested relative to his/her employment, employment applications, and other related matters, and to furnish copies of any and all records which the employer may have regarding his/her employment.
Release Of Information Form Mental Health In Philadelphia
Category:
State:
Multi-State
County:
Philadelphia
Control #:
US-00458
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
You do not automatically have the right to get a deceased person's medical records, even if you are a close relative of theirs.
If you need to send clinical information about a patient and are not sure which number to use, send it to our central fax number: 1-844-FAX-CHOP (1-844-329-2467). Faxes are securely scanned and emailed to the clinical area you specify.
Retention Requirements & Record Ownership In Pennsylvania, physicians must retain an adult patient's medical records for at least seven years from the last date of service. Requirements differ slightly for minor patients.
§ 16.95. (a) A physician shall maintain medical records for patients which accurately, legibly and completely reflect the evaluation and treatment of the patient. The components of the records are not required to be maintained at a single location. Entries in the medical record shall be made in a timely manner.
(d) To meet the requirements of this section, so as to provide a formal record for review, but not necessarily for other legal purposes, a psychologist shall assure that all data entries in professional records are maintained for at least 5 years after the last date that service was rendered.
Section 25.213 - Medical records (a) A medical record shall be maintained for each patient, identifying the patient, the person making the entry, the date of each contact, pertinent clinical information, diagnoses, findings, laboratory results and other diagnostic, corrective or therapeutic procedures, including ...
Check their website: Information about how to get your health record may be found under the Contact Us section of a provider's website. It may direct you to an online portal, a phone number, an email address, or a form. Phone or visit: You can also call or visit your provider and ask them how to get your health record.
Reach out to the Pennsylvania Department of Health by calling 877.774. 4748 or emailing pasiis@state.pa.
Visit My Penn State Hershey Health The easiest way to access your electronic medical records is through our secure website for patient tools and information, My Penn State Hershey Health. This site gives you access to your medical records and test results, where you can print a copy for your needs.
Lancaster General Health Medical Record Services: 717-544-5911. Hospital of the University of Pennsylvania Medical Records Department: 215-662-3154.
