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PATIENT MEDICAL RECORD # ... B. PERMISSION TO SHARE: I give my permission to share my protected health ... contact 617-726-1798 / Fax 617-724-0264.

Medical Records The Medical Records Department keeps patient information for both inpatients and outpatients at Boston Children's Hospital. Our office is open Monday through Friday, 8 a.m. to 4:30 p.m. and can be reached at 617-355-7546. Please note our office is located at an off-site location and cannot accommodate walk in customers.

To obtain a copy or request that your health information (medical records) be sent to another healthcare facility/provider, insurance companies, attorneys, ...

AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION (PHI) 999860 Rev. 06/17 999860 Mailing Address: Medical Record Department Fax: 617-414-4210

Attn: Medical Records (BCH3040) 300 Longwood Avenue Boston, MA 02115. Fax: 617-730-4675 Phone: 617-355-7544. Radiology. Authorization for Release of Radiology Images form. For release of x-rays or other radiological images, please fax your request to the Department of Radiology Image Service Center at 617-730-0538.

NOTE: Sending your medical records through email is not a secure method and may put your medical records and personal information at risk. TO REQUEST THE RELEASE OF SPECIFICALLY PROTECTED OR PRIVILEGED INFORMATION, YOU MUST INITIAL BELOW: _____ HIV Test Results (PATIENT AUTHORIZATION REQUIRED FOR EACH RELEASE REQUEST).

For release of x-rays or other radiological images, please fax your request to the Department of Radiology Image Service Center at 617-730-0538. How we protect ...

Boston Medical Center Health Information Management (Medical Records) Release of Information Unit/Basement Yawkey Building 850 Harrison Avenue Boston, MA 02118 For general radiology images, films or medical records, please contact the …

Thank you. To obtain a copy of your medical record, this release of information form must be properly filled out and mailed to the Health Information Management ...

The SHS Medical Records group is dedicated to maintaining your medical records and keeping your health information private and secure in accordance with federal privacy and state regulations. Medical records are kept for 20 years after the patient’s last visit or final treatment.

Boston Medical Center 85 E Concord Street 1st Floor Boston, MA 02118. Medical Records Office for Mailing or Hand Delivering Authorizations or Picking Up Documents. Boston Medical Center Health Information Management (Medical Records) Release of Information Unit, Basement Yawkey Building 850 Harrison Avenue Boston, MA 02118. Helpful Phone Numbers

Requests for medical records must be directed to medical providers. All fields are required. Incomplete or incorrect forms will be returned. The provision of ...

Patients may request their medical records at any time. A patient, or his/her legal representative, may inspect and/or obtain a copy of his/her medical records, or have copies of medical records sent to another facility.

Attn: Medical Records Beth Israel Deaconess Medical Center 330 Brookline Avenue, RA-OB14 Boston, MA 02215. We will mail your records to the address specified on the release of information form. For patient privacy protection, we do not fax or email medical records (except in the case of emergency care) to the provider. The average turnaround ...

To protect a patient's privacy, we do not fax, except in the case of emergency care, to the provider. Please Note: The Medical Records Health Information ...

Bmc Medical Records Release Form! bmc medical records dept, exclusive hospital ratings help you find a doctor who can treat you at the best hospital, ...

Medical Record Release Form Allow 7–15 days for the retrieval, copying, and forwarding of your medical records. Copies of records will not be faxed but will be mailed or can be picked up at Health Services during normal operating hours.

Medical Records If you are a patient of the East Boston Neighborhood Health Center and have a medical records or forms request, contact you primary care provider's office through MyChart or by phone. If you do not have a primary care provider, call 617-569-5800. Your good health matters. And so does your personal medical information.