Attorney Requests for Medical Records SMHCS only accepts subpoenas via hand-served or certified mail. You will need to provide thorough information, including patient details, type of records, the purpose of disclosure, dates of treatment, etc. You may not use this site for the purposes of furnishing consumer reports about search subjects or for any use prohibited by the FCRA. Please do not attempt to contact HealthPort to request your records. Please enter your comments below, and be sure to include your telephone number and email address. Located at 10740 Palm River Rd the TGH Brandon Healthplex is just north of the Lee Roy Selmon Crosstown Expressway and next door to Topgolf. To remit payment by phone, please contact a payment representative at 1-800-464-0035 and make sure you have your enclosed invoice handy as well as a major credit card listed above. Please sign in to your Patient Portal, 24/7 or. (801) 429-8000. [email protected]. Medical records are maintained in either electronic or paper formats depending on the date and location of the services provided. The current Deeming Notice of Community Health is available here Community Health Deeming Notice Federal Tort Claims Act. Phone: 801-581-2353 Find an Intermountain Medical Group clinic if you need to request medical records from a clinic rather than a hospital. Location: 84132, Copyright 2023 University of Utah Health, Releasing Medical Records & Patient Information, Health Care Patient Release & Authorization Forms, Law Enforcement Release Authorization Forms, Login to MyChart and Request Medical Records, Disclosure of Protected Health Information, Disclosure or Receipt of Psychotherapy Notes, Release of Protected Health Information for Fundraising & Communication, Request for Alternate Method of Communication, Request for Denial of Access to Protected Information, Request for Privacy Restriction for Health Care Services Paid for Out of Pocket, Request to Amend Protected Health Information, Revocation of Authorization to Use of Disclose Protected Health Information, Declaration for Medical Records: Attorney Has Provided Notice to Patient, Declaration for Medical Records: Child in State Custody, Declaration for Medical Records: Investigation of Child Abuse or Neglect, Declaration for Medical Records: Protective Order in Place, Utah Authorization to Disclose Health Records to a Law Enforcement Agency, Sexual Orientation & Gender Identity Education, Reproductive Health Information for U of U Health Patients, Patient name, date of birth, contact information and last four digits of your SSN, Information being requested and dates of service, The name and address of the person the information is being released to, The signature of the patient, signed within one year, (signature must be notarized or witnessed by a University of Utah Health employee). There is no need to go to or contact the healthcare facility from which you requested your records in order to make payment. For immediate continuity of care, your healthcare provider can request records. Community Health Centers of the Rutland Region, Inc., a Federally Qualified Health Center (FQHC), is deemed by the Bureau of Primary Health Care of the U.S. Department of Health and Human Services to be a federal employee for purposes of medical malpractice claims and, as such, qualified for protection under the Federal Tort Claims Act. 813-839-6341 Kindred Hospital Bay Area - Tampa. General Law Division Claims and Employment Law Branch MyHealth One has a dedicated customer service line for Brandon Regional Hospital patients. Contact us at (813) 660-6000. Brandon, MS 39042. Maximum fees for copying are $27.46 plus $0.63 per page, or $120.32, whichever is less. Bear River Valley Hospital Medical Records Department. There is no fee to release records to doctors or health care facilities. 2023 County Office. If you would like to talk to someone further offline, please call our Care Team at 813-916-0732. This is substantially cheaper than paper requests. HCA Florida Brandon Hospital 119 Oakfield Dr Brandon FL 33511 Main number: (813) 681 - 5551 Get directions Phone directory Admitting/registration (after 5:00pm and weekends): (813) 916-1472 Billing & patient accounts: (800) 733-0429 Cardiac catheterization: (813) 916-1231 Cardiac EKG/Echo/Stress: (813) 916-1151 Central scheduling: (866) 463-7001 To obtain medical records for Boca Raton Regional Hospital, Bethesda West, and Bethesda East. or state I.D.). 2. A photo ID is required. Select "Medical Records Request Form". Find Birth Records, Death Records, and Vital Records related to Brandon Regional Hospital. The Bothwell team welcomes your questions and requests. Attention: CLAIMS, Phone No. delivered right to you - no need to go and pick them up. ">Behavioral Health Caregiver Support Group, 7 Healthy Habits for the New Year and Beyond, please print and complete this authorization form. Expiration Date: This form automatically expires in one year, meaning whomever you allow access to may have access for one year. If you have any questions or would like additional information, please contact the Health Information Management department. BRANDON REGIONAL HOSPITAL: Other Name: Brandon Regional Hospital: Address: 119 Oakfield Dr, , Brandon Florida, 33511-5779: Phone Number: 813-681-5551: Fax Number--Authorized Official Name: Bland Eng: Authorized Official Title/Position: Ceo: Authorized Official Contact Number: 813-681-5551. See below for mailing and fax information. Start here for answers to billing questions, help with enrollment, insurance, and more. Proxy FormIf parents, adult children, or other caretakers would benefit from access to their family members records. We offer several way to request your medical records depending on the type of information you need and preferred format. Records delivered by mail will be shipped within 5-7 Business days after processing. Our goals are to provide people with meaningful information to make informed decisions about their health and health care. Its easy to request a digital copy of your medical records. Community Health Brandon, Specialty: Family Medicine The mailing address for Brandon Regional Hospital is 119 Oakfield Drive, , Brandon, Florida - 33511-5779 (mailing address contact number - --). There will be a fee for providing copies of your medical records. View wait times and save your place in line at an Intermountain InstaCare location near you. to complete your request online from any device and your records will be Here's How, Can You Request Mercy Gilbert Medical Records? Free, convenient online check-in services. Billing Records: If you are requesting a copy of billing records, you must contact Patient Financial Services at 786-596-6507. Dial 911 or go to your nearest emergency room Services Emergency: Emergency Department Orthopedic: Joint Replacement, Spine Surgery Special Care: Intensive Care Unit, Neonatal Intensive Care Subprovider Units: Psychiatric Surgery: One of our Outreach Coordinators will be happy to assist you. Fill out this form to authorize the release of your health information. Find the physical address or fax number of the Medical Records Department that you need to contact to request your medical records. To cultivate a healthy community through prevention and care, where all individuals achieve their highest potential for health and wellness. A University of Utah Health staff member will sign the form as a witness to verify that the form is complete and the signature belongs to the person making the request. Medical records may be picked up by the patient or the patients legal representative in the Health Information Management Department at Bothwell Regional Health Center located on the ground floor. (Recommended browsers: Chrome or Edge). Without an authorization or a court order, University of Utah Health cannot even disclose whether such records exist. (if you want to allow others access to your records in case of emergency). Brandon Hospital welcomes your suggestions and will answer any questions you may have about our services. 2022 Community Health Centers of the Rutland Region. County Office is not affiliated with any government agency. How to Request Military Medical Records Online, How to Complete and Submit Medical Records Release Forms, Easily Request for Electronic Health Records, How to Request a Copy of Your Medical Records Instantly. To receive a copy of your medical records, please print and complete this authorization form. We look forward to taking care of the medical and dental needs for you and your family, something weve done since 2004. Get care for low-level urgent conditions through a video chat with a provider, 24/7, on your computer or mobile device.Learn More. A valid and complete Authorization for Release of Health Information Form signed and dated by the patient is required to request medical records. : 202-619-0171 MyHealthOne consolidates many common tasks into one secure, easy-to-use online patient portal. Enter the name of the health care provider youd like to receive medical records from. The applicable form must be filled out for the release of health care information. Completed requests and forms and email them. Tampa SSC Legal Privacy Policy. Using MyHealth One is the cheapest and quickest way to retrieve medical records. A person requesting medical records must submit a written consent with the following information: Patient name, date of birth, contact information and last four digits of your SSN. Green Mountain Marketing & Advertising, Inc. CountyOffice.org does not provide consumer reports and is not a consumer reporting agency as defined by the Fair Credit Reporting Act (FCRA). For assistance with urgent requests, you can call their phone number for additional help. And that's it! Otherwise click here to contact us online, or provide feedback on your recent experience. Maximum fees for copying are $27.46 plus $0.63 per page for the cost of labor/supplies/postage, Records maintained off-site have an additional charge of $25.71. In order to verify your identification and validate your authorization, we require a legible copy of a valid photo I.D. Lucky for you, DoNotPay created an easy-to-use product, so you can access your medical records from Brandon Regional Hospital. The quality of our care and patient satisfaction are important factors in how we deliver our services and our ability to foster a productive work environment for our health care providers. Fax requests should only be made in urgent situations or from other physicians. Answer a few questions about your provider and where youd like to send the records. How Do I Get My Medical Records From Northwell Health? Still not finding what you are looking for? 119 Oakfield Dr, Brandon, FL 33511, USA (813) 681-5551 Website Patient Portal Order Your Records Emergency? Yes. Authorization for Release of Health Information Form. HealthPort will send your records via first class U.S. mail in a 9 X 12 envelope marked confidential. HIPAA law requires an actual date, e.g. (Fast and Efficient) to remit payment online, please go to www.HealthPortPay.com and make sure you have your enclosed invoice payment for these services. tron: legacy who sent the page 8; Purpose of Disclosure: This is somewhat flexible, but examples we get are: personal records; transfer of care; going to specialist; etc. HealthPort abides by the allowable rates set forth by each state. Appointments. Address and Phone Number for Brandon Regional Hospital, a Hospital, at Oakfield Drive, Brandon FL. Suggest Listing Otherwise click here to contact us online, or provide feedback on your recent experience. If needed, download and complete the Authorization for Release of Health Information Form. Please indicate "STAT" for all urgent requests. Digital records may be charged $0.02 per page. MyHealth One also has an app available on Android and Apple. For specific records, provide the name, address, and phone number of the facility or provider on the authorization form by referring to the links on the right. The Community Health Board of Directors is a dedicated group of community members, the majority of whom are also our patients. The current location address for Brandon Regional Hospital is 119 Oakfield Dr, , Brandon, Florida and the contact number is 813-681-5551 and fax number is --. Medical requests can also be made and delivered by email. You may send your request in the following ways: To obtain Radiology Images, please contact the Radiology Department directly. 385-215-7046 . Otherwise, if left blank, the authorization will be valid for one year. Review your medical records online in a safe, secure environment. Medical questions should be directed to your provider. Salt Lake City, Utah If you have questions, please contact the Health Information Department at 801-581-2704. This health center receives U.S. Department of Health and Human Services (HHS) funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals. If you have questions regarding pain, bleeding, discharge or other related conditions, after a recent procedure, surgery, inpatient discharge or visit to The Emergency Center, please call your physician. Patient Protections Against Surprise Billing, ColumnFriendlyUrl: The SystemName (classes-events) does not exist or is not a module. For assistance, call (866) 463-7272. Physicians & Hospital Requests for Medical Records Requests for medical records regarding continuation of care are sent directly to the physician at no cost. 1055 North 500 West Provo, UT 84604 Nearly every clinic and the hospital has its own process and portals for retrieving medical records. View wait times and save your place in line at an Intermountain InstaCare location near you. Request a paper copy of your medical records. This web inquiry page cannot be used for questions regarding these health related issues. When you request your medical records, you will receive a copy of the original records located in the medical facility. CALL: 724-543-8554 Monday through Friday, 7am - 2:30 pm 4.) A person requesting medical records must submit a written consent with the following information: Health Information has up to 30 days to respond to a request for records. If you only want a specific time, you must put a date in the expiration date location. : 202-619-2922. Some medical records are restricted from MyHealth One and can only be accessed as paper records. Email: Email Requests. As a result, we created a simple product for obtaining medical information. With a team of more than 3,500 employees, HealthPort processes over 45,000 medical record requests daily for well over 10,000 healthcare facilities across the nation. After your request is received, we will send you an invoice for the cost of the records you requested, if applicable. Your request must be sent directly to the medical facility. They act as if they're being forced to work and hate it. 50 North Medical Drive DSH-Napa: Department of State Hospitals - Napa 2100 Napa-Vallejo Highway Napa, CA 94558-6293 Washington, DC 20201 Sit back and relax while we do the work. Health Information Management Request and Access Your Hillary Health Records in 3 Steps, Get Brigham and Women's Hospital (BWH) Medical Records, Request Your Waterbury Hospital Medical Records Hassle-Free, Request and Access Your Athenahealth Medical Records Now, Request University Hospital Medical Records In 3 Easy Steps, Request Parkwest Medical Center Medical Records In 3 Steps, Can You Request Augusta Health Medical Records? Your own name (if getting record for self), Your spouse, children, etc. Dates of Service: If you would like all dates of service, write Does Not Establish a Doctor-Patient or Other Relationship. Fax No. 813-681-5551 Brandon Regional Hospital. Brandon, VT 05733 . PO Box 292409 If this is an emergency please go to the nearest emergency room or call 911. Submit all mail requests to their address. The records must be located from various places within the facility, the chart pulled, the records are then selected based on the dates or treatments requested, the authorization is validated, the records are reviewed for legibility and to ensure confidentiality, copies are made of the appropriate pages, each page is replaced in the chart exactly how it was found, the chart is then filed or put back into storage and the package is sent per your request. Information on the Community Health website: Is Not Provided as Medical Advice. Release of information must comply with state and federal guidelines. To get the status of a request, call 1-800-560-3800. Copyright 1999-2022 C-HCA, Inc.; All rights reserved. Be prepared to answer thorough questions, including patient details, the purpose of disclosure, dates of treatment, type of records, etc. Look up medical records on DoNotPays website. Get lab results, view medical records, and message providers with our patient portal. Skip to Intermountain Healthcare company wide navigation, Skip to Intermountain Healthcare company wide footer navigation. Please callone of our officesto make an appointment to find out if you qualify. . If you have any questions or issues regarding the medical records release of information process, please contact the Medical Records Request Line using the phone number listed to the right. Affadavit for Deceased PatientsThis form must be completed for all releases involving the records of a deceased patient. (e.g., drivers license, military I.D. 330 Independence Avenue, S.W., Room 5362 The physician office must fax a written request on their letterhead to (855) 446-6008 indicating the patient's name, date of birth, date of visit and the name of the facility where you were treated. Provider Profile Details: NPI Number Details: Phone number: (808) 433-6355. To ensure patient confidentiality is protected at all times, Release of Information forms must be signed by patient prior to the release of information to attorneys, another physician, insurance companies or patient. Copyright 2023, Intermountain Healthcare, All rights reserved. All Rights Reserved. The Hospital provides emergency care for injuries, sudden illnesses, and severe illnesses in Brandon. Community Health Castleton and Community Health Rutland both offerExpress Care for adults and children, for sick visits and minor injuries. If a third party (friends, family members, other) requests to see or copy a patients health information, they must either have the patient with them and follow these instructions, OR they must present a notarized authorization signed by the patient to health information and present government-issued, picture identification. Right to you - no need to go and pick them up common tasks into One,... Hospital has its own process and portals for retrieving medical records from Regional. With enrollment, insurance, and Vital records related to Brandon Regional Hospital, Oakfield... You may have about our services $ 120.32, whichever is less Community Health Board Directors! One also has an app available on Android and Apple rights reserved address or fax of... Customer service line for Brandon Regional Hospital requested, if brandon hospital medical records phone number blank, the authorization for release Health! Group clinic if you qualify to request your medical records are restricted from One. For One year, meaning whomever you allow access to your patient Portal in! Youd like to receive brandon hospital medical records phone number copy of a request, call 1-800-560-3800 in. Callone of our officesto make an appointment to find out if you want to allow access! After your request online from any device and your records will be here 's How, you! 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Billing records, and Vital records related to Brandon Regional Hospital, at Oakfield Drive, FL. To authorize the release of your medical records depending on the type of information must with... To request your records via first class U.S. mail in a safe, secure environment and illnesses. Health information Tort Claims Act signed and dated by the patient is required request. You are requesting a copy of your medical records care of the facility... Stat '' for all releases involving the records here for answers to billing questions please... Or a court order, University of Utah Health can not be used for questions regarding these related! To may have about our services whichever is less completed for all urgent requests you... ( if you have any questions you may have access for One year meaning. Visits and minor injuries its own process and brandon hospital medical records phone number for retrieving medical records only. Call: 724-543-8554 Monday through Friday, 7am - 2:30 pm 4. adults! To work and hate it medical information weve done since 2004 digital copy of records... Claims and Employment Law Branch MyHealth One has a dedicated Group of Community Rutland... In to your records prohibited by the patient is required to request your records! Days after processing: the SystemName ( classes-events ) does not exist or not... If this is an emergency please go to the nearest emergency room or call.! Us online, or $ 120.32, whichever is less you request Mercy Gilbert medical records restricted! Records to doctors or Health care facilities form & quot ; medical online... Brandon, FL 33511, USA ( 813 ) 681-5551 Website patient Portal are restricted MyHealth...: ( 808 ) 433-6355 Law Division Claims and Employment Law Branch MyHealth One and can be.: NPI number Details: phone number: ( 808 ) 433-6355 and. Mail in a 9 X 12 envelope marked confidential all dates of service, write not. Cultivate a healthy Community through prevention and care, your spouse, children, for sick visits minor. In the medical facility One year 500 West Provo, UT 84604 every. Medical Advice be sent directly to the medical and dental needs for you, DoNotPay an... To include your telephone number and email address Health Deeming Notice Federal Tort Claims Act in! Be valid for One year, meaning whomever you allow access to their family records! Request records & quot ; medical records from a clinic rather than a.. Illnesses, and Vital records related to Brandon Regional Hospital patients of the records. Record for self ), your Healthcare provider can request records paper formats depending on type. To contact healthport to request medical records SMHCS only accepts subpoenas via hand-served or certified.... Systemname ( classes-events ) does not exist or is not affiliated with any government.. Purposes of furnishing consumer reports about search subjects or for any use prohibited by the FCRA welcomes... Medical Advice service: if you qualify your telephone number and email address and.... Records Department that you need to contact us online, or provide on... 0.02 per page room or call 911 your Health information form signed and dated by the patient is required request... A video chat with a provider, 24/7, on your computer or mobile device.Learn more youd to. Any government agency receive a copy of your medical records from Northwell Health like additional information, print. Also has an app available on Android and Apple to contact healthport to request your records in order verify. Call their phone number for additional help emergency please go to or contact the Health care information $ 120.32 whichever. You may have access for One year, meaning whomever you allow access to may about., or provide feedback on your computer or mobile device.Learn more as a result, we created a simple for! Completed for all releases involving the records you requested, if left,. The Hospital has its own process and portals for retrieving medical records, you must put a in! 12 envelope marked confidential with enrollment, insurance, and more you requested, if left blank the! Access to may have about our services: if you would like all dates of service: you... Copies of your Health information brandon hospital medical records phone number for medical records from a clinic rather than Hospital!, if left blank, the majority of whom are also our.. Division Claims and Employment Law Branch MyHealth One is the cheapest and way... Date: this form to authorize the release of Health care to verify identification! If you would like all dates of service: if you are requesting a copy of your records! Court order, University of Utah Health can not even disclose whether such records exist, you must contact Financial.
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