Αποτελέσματα Αναζήτησης
Request medical records via secure website hosted by our release of information partner, Ciox by completing the form here. If you are unable to complete your request online, refer to additional options to submit your medical records request, or contact the HIM team.
- 8083-003 Authorization to Release Information - Gillette Children's
Gillette Children's Specialty Healthcare . Release of...
- 8083-003 Authorization to Release Information - Gillette Children's
Gillette Children's Specialty Healthcare . Release of Information-mail code 205515 200 University Ave. E. St. Paul MN 55101 . Phone 651-312-3122 . Fax 651-229-3888
Information to be Released: Check the appropriate box(es) below regarding information to be released for the following dates: From: to Records Pertaining to: Other – (Please specify individual options)
You must tell Gillette, in writing, if you want to revoke your authorization (that is, if you want to stop any future release of information that you previously allowed by filling out this form). 1. Write the patient’s name and date of birth clearly and legibly. Gillette will add the patient’s medical record number.
Copies of medical records are available from our Health Information Management department (open 8:00 a.m. to 4:30 p.m., Monday-Friday). You can contact our team by phone (612-813-6216) or via fax (612-813-5980). Processing requests for copies can take up to five working days.
Scan or take a photo of your completed form. Log in to your MyChildren’s account. Create a new message in MyChildren’s. Attach this completed form and send to. Health Information Management. *Option available if you have been seen at the Minneapolis or St. Paul hospital or clinic locations.
See what is usually included in a medical record. If you are a provider, please contact Health Information Management at 612-813-6216 to obtain copies of medical records. Reach us 24/7 for patient referrals, consults, admissions and neonatal transport.
