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Please complete the SH 48 form
How do I request a copy of my medical record?
Please complete the Patient access form.
How do I request access to my deceased relative’s medical record?
If you are the executor/administrator of the estate, please complete a Patient Access Form and provide a copy of the court documentation. If an executor/administrator has not yet been chosen, please complete a distributee certification form and a patient access form. You will also need to submit a copy of the death certificate. Forms can be found on the ROI Forms page.
I have an HIV related condition. What form do I need?
Please complete OCA form 960.
My son is a 19-year old college student. My insurance pays his hospital bills and I claim him as a dependent on my income tax. Why can’t I see his medical records?
By law, only the adult (age 18 or older) patient or a legally designated representative has the authority to release the information contained in a medical record about him/her, regardless of who is paying the bills. Legally designated representatives include court appointed guardians or others with power of attorney for the patient. For children under age 18, only a parent or a court appointed guardian may authorize release of medical information.
My mother died last year. Can I request a copy of her medical records?
The next of kin or personal representative of the estate may request those records. It may be necessary to verify that the patient has actually died and the identity of the next of kin. If you are the executor/administrator of the estate, please complete a patient access form and provide a copy of the court documentation. If an executor/administrator has not yet been chosen, please complete a distributee certification form and a patient access form. Forms can be found on the ROI Forms page.
How long will you keep my medical record?
Medical records are retained for 21 years.
My husband and I are divorced. Can we both have access to our children’s medical records?
Yes, unless parental rights have been severed by the court.
How can one of my outside doctors get copies of my medical records?
Another healthcare provider (for example, a physician, nurse practitioner, or physical therapist) who is treating you can request copies of your health information at any time. It may be necessary to verify that this provider is currently treating you. The healthcare provider should submit a request in writing. In some instances, a signed HIPAA compliant authorization may be necessary.
How do I get a copy of my Birth Certificate?
You will need to contact the City Clerk’s office at (585) 396-5000 ext 5017.
If you have any questions, please contact us:
Thompson HospitalHealth Information ManagementRelease of Information350 Parrish St.Canandaigua, NY 14424Phone: (585) 919-3849Fax: (585) 396-4761or (585) 396-6929
Mon.-Fri. 9 am - 4 pm