Release of Information/Medical Records
Thomas Jefferson University Hospital is committed to protecting your privacy. Hospital staff members treat your medical information
in compliance with federal and state requirements.
The TJUH Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you may access this information. Medical records
will not be released without a written authorization. For continued patient care directly to a physician’s office or healthcare facility or in the event of an emergency,
Jefferson may also request written authorization by the patient or responsible physician.
To authorize us to forward a copy of your medical record directly to a physician you must complete the “Authorization to Release Protected Health Information” form (PDF file - Download Acrobat Reader Free) available online or from our office or a similar release form supplied by your healthcare provider. Usually this is limited
to key documents in the record rather than copies of the entire record. In an emergency situation, your records may be sent
to another hospital without authorization.When you request your records, there may be a charge for photocopies. Please reference
the FAQ titled “Do I have to pay for copies?”
Patients may request access to view their medical information. Appointments must be made in advance with the Release of Information
Staff. When the patient arrives, they will be requested to complete a form related to that request.
For questions regarding requests for copies of medical records, please contact the Release of Information staff at 215-955-1165
or 215-955-8777. Business hours are 8:00 am to 5:00 pm, Monday through Friday.
Frequently Asked Questions (FAQ's):
How can I get a copy of my medical records?
To get a copy of your medical records, you must complete the “Authorization to Release Protected Health Information” form.
Download and print the form [PDF file, including instructions] (Download Acrobat Reader Free) or obtain a copy from our office. We would also be happy to fax or mail a copy of the release form to you.
A few important notes:
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The authorization form must be signed by the patient. |
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The social security field is optional. |
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Signatures other than the patient's must have documentation of authority to sign. A valid ID may be required. |
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You can return the completed, signed form in person or by mail. |
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Please allow five to 10 business days for processing.
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Do I have to sign an authorization?
Yes. Your written request is required by law (MCC 333.26265). The request must be signed and dated within the past year unless
otherwise indicated.
Please note that you may revoke your authorization, in writing, at any time. This would not apply to any information already
released.
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Do I have to pay for copies?
The first copy of your medical record that you requested be forwarded to you will be free of charge.
If you submit a second request for a copy of the same medical record, there will be a charge to cover the photocopying costs.
This is authorized by a Pennsylvania Department of Health Notice regulated by Pennsylvania Act 26. Jefferson sets fees in
accordance with this Notice which is updated January 1st of each year.
Jefferson does not charge a fee for information requested by or for your physician for continuity of care.
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Can you give me my medical information over the phone or by fax?
Phone: We are not able to confirm identity over the telephone. Thus, due to the need to protect patient confidentiality, we do not
supply information over the phone. Additionally, please note that we are not clinical personnel and cannot explain test results.
Fax: In the case of immediate patient care purposes, we can fax records to a physician’s office or healthcare facility. It is
not necessary that the patient be in the office when the fax is received – only that an appointment is scheduled for some
time that day or the next. Otherwise, copies of medical records will be mailed or held for pickup. Whenever possible, please
request records far enough in advance so they can be mailed.
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Do you accept faxed authorizations from other healthcare facilities?
Authorizations from other facilities or physicians: Yes, as long as they are legible and they contain the required information in a valid authorization, which is:
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Patient’s full name and date of birth. |
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Name of the organization from which records are being requested. |
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Name and address of the organization or person to receive the record. |
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Specific information to be sent such as type of documents/reports needed, dates of treatment or medical condition
*Please Note: Drug and alcohol abuse treatment records, metal health records and/or HIV/AIDS information cannot be disclosed
unless specifically authorized. |
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Purpose for which the information may be disclosed. |
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Expiration date or event. |
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Signature of the patient or the patient's legal representative. If the patient’s personal representative signs the authorization,
the supporting legal documentation must be provided.
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Date the form is signed. |
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Does my family physician get copies of my medical records?
If your family physician is your attending physician while you are in the hospital, they will receive access to and copies
of pertinent reports. (An attending physician is the physician primarily responsible for your care while you are in the hospital.) If your attending physician is not your family physician, your family physician may not automatically get copies of your reports. They may get discharge instructions
and related medication information. In addition, although the attending physician usually directs that copies of discharge
summaries be sent to your family physician, this is generally addressed on a case-by-case basis.
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Who should sign a release of records for a minor?
Biological parents. With certain legal exceptions, biological parents have an equal right to a child’s medical information. Access can be denied
only if they have been stripped of all parental rights. We must have knowledge of the lack of parental rights to facilitate
the denial.
Biological parents (never married). Unless otherwise ordered by the court, only the biological mother has the ability to sign the release of information authorization.
However, an Acknowledgement of Paternity and the inclusion of the father’s name on the birth certificate does provide the
father with authority to release records.
Stepparents. Without an order of the court, stepparents do not have the necessary authority to consent to the release of a minor’s medical
records.
Adoptive parents. Adoptive parents must provide the consent for the release of a minor child’s medical record, as the biological parents' parental
rights have been terminated.
Minors. Pennsylvania law sometimes allows a minor to consent to his/her own treatment without parental consent. In this case, only
the minor has the right of access to those treatment records. If you need additional information related to this, please contact
Health Information Management.
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Can a parent sign a release for a child who is 18 or older?
No. In Pennsylvania, in order to legally authorize the release of information, the patient would have to sign for himself/herself,
unless a legal guardian has been established by the court. Documentation of authority to sign for the patient must be provided.
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How do I have someone else pick up my medical records for me?
There are two ways to facilitate a third-party pick-up:
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On the signed authorization form, specify that your records can be released to that person.
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Provide a letter with your signature, the date and authorization for this person to pick up your records. We must be able
to confirm that it is actually your signature. We must also be able to confirm the identity of the person picking up your
records.
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How can my spouse get my medical records?
To obtain your medical records, your spouse must have valid authorization – signed by you or your legal representative – specifying
that your medical records may be released to him/her.
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Under what circumstances can I get the records of a deceased patient?
Jefferson releases these records in conformance with PA Code 115.29 - "Upon the death of a patient, the hospital shall provide, upon request, to the executor of the decedent’s estate, or, in
the absence of an executor, the next of kin responsible for the disposition of the remains, access to all medical records
of the deceased patient. The patient or the patient’s next of kin may be charged for the cost of reproducing the copies;
however, the charges shall be reasonably related to the cost of making the copy."
Life insurance companies may obtain records for the purposes of payment of benefits if the request from the company is accompanied
by a release from the executor of the estate or the next of kin responsible for the disposition of the remains.
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