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Health Information Management Department

Medical Records Frequently Asked Questions

To request your medical records please use either of the following:

What is a medical record?

The terms medical record, health record, and medical chart are used interchangeably to describe the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdiction.

The medical record includes a variety of types of "notes" entered over time by health care professionals, recording observations and administration of drugs and therapies, orders for the administration of drugs and therapies, test results, x-rays, reports, etc. The maintenance of complete and accurate medical records is a requirement of health care providers and is generally enforced as a licensing or certification prerequisite.

Frequently Asked Questions

Please review these questions and answers, and reach out to us if you need further assistance.

The Health Insurance Portability & Accountability Act (HIPAA) sets the standard for a valid authorization to release information. The following elements must be included for a HIPAA-compliant authorization:

  • Name and date of birth
  • Authorized person/s receiving health information
  • Purpose of Disclosure
  • Type of information to be disclosed
  • What format should the information be disclosed (USB drive, CD, etc.)
  • Purpose for discloser
  • NewYork State requires a special authorization for the release of information regarding: Mental Health, any HIV-related condition and drug and alcohol abuse
  • Statement acknowledging the patient's right to revoke or cancel authorization
  • Statement that information disclosed pursuant to the authorization may be subject to re-disclosure and is no longer protected under this authorization
  • An expiration dates
  • Signature of patient or patient’s representative
  • Yes, the patient portal is a secure online website that gives you convenient, 24-hour access to your personal health information from anywhere with an internet connection. Using a secure username and password, you can view health information such as; Recent doctor visits, Discharge summaries, Lab reports. Etc.
  • There are no fees for registered patients to access MyDownstateCare Patient Portal which is our secure online platform for your health information/medical records.

No fee will be charged for records copied at the request of a health care provider (i.e. physician, nurse practitioner, nurse, etc.) or for records sent to a health care provider at the request of the patient for the purpose of continuity of care. however; a fee will be charged for copies of records requested by the patient for his/ her own purposes, as well as for third party requests, including attorneys representing patients. If you request records other than for continuity of care, we require payment prior to the release of records.  An authorization form must be completed, signed and dated in order for your request/s to be processed.  An invoice will be sent to the address listed on the Patient Authorization for Release form. Once payment is received, records will be released in the desired format.  Payments can be made by Credit Card, Debit Card, or Check. Please make all checks payable to copy company instead of SUNY Downstate Health Sciences University. Fees for medical records are state regulated and listed below.

Patient Portal Link

 

Fees:

Photocopies: $0.39/page for first 200 pages; $0.12/page for pages 201-400; Free for >400 pages.

Electronic media / Email: Flat fee of $6.50

Mammograms: Flat fee of $6.50

Summaries/ Explanations: Dependent upon number of hours and physician hourly consult rate.

(Fees do not apply to requests for medical records in support of an application for government benefits)

The following provides a brief summary of the various documents within the medical record which may help you to clarify which document/s to request:

Completely fill out the form in it's entirety. Include dates of service (if no dates are given, we will provide an abstract of your last visit) and type of document/s needed, for example:

  • Discharge Summary
  • History & Physical
  • Laboratory results
  • Consultation
  • Emergency Room Report
  • Operative Report
  • Clinic Visit/Office Visits
  • Pathology Report
  • EKG
  • Medication List
  • X-Ray reports/films/imaging reports
  • Request a copy of your entire record

The average request takes less than 10 days, SUNY Downstate Health Sciences University will process your request as soon as possible.  If there are delays we will notify you.

Through Healthix with patient consent or permission at registration; patients are given a consent form that will allow providers to access their health information: Healthix is the largest public Health Information Exchange (HIE) in the nation, serving New York City and Long Island.  They are committed to securely exchanging patient data to improve the quality and efficiency of care. Healthix collects and aggregates patient information from thousands of providers in the Greater New York area. Patient data is made available to providers with patient consent.

Patients can request their medical records via the Health Information Management Department by completing the authorization form.

You can download the Patient Authorization for Release form or OCA Form 960

  • Patients and/or legal representatives  
  • Parent if the patient is a minor
  • Emancipated Minors
  • Legal Guardian (with proof of Legal Guardianship)
  • Power of Attorney (Power of Attorney document/s must be presented to the HIM Department)
  • Executor of estate for deceased patient or a copy of a death certificate including an Affidavit for the Release of a Decedent’s Health Information.

Durable Power of Attorney (POA):

  •  A legible copy of the POA in addition to a copy of a signed HIPAA authorization form with a valid State Identification.
  • For addition information, please contact the Release of Information at 718-270-1845 or 718 270-2891

Only persons authorized under the City, State and Federal laws. The information contained within the medical record belongs to the patient. Medical Records are the property of SUNY Downstate Health Science University. Patient medical records are maintained and released in accordance with legal, accrediting, and regulatory requirements.

Legal guardianship is assigned by a court, such as the family court, according to state laws.

A valid State picture ID.

Examples: New York State Driver’s License and Passport.

New York State law lists surviving spouses as the first next of kin, following by the surviving children.

To request your medical records, you need to complete our Patient Authorization for Release form. You may come onsite the office hours are Monday - Friday 8:00 a.m. to 5:00 p.m.,

You can download the Patient Authorization for Release form or OCA Form 960, and send the completed form to this mailing address:

SUNY Downstate Health Sciences University
Release Of Information Unit (ROI) 
450 Clarkson Ave
HIM Dept. MSC #119
Brooklyn NY, 11203

To follow-up on the status of your request, please contact us:

Phone numbers: 718-270-2891 / 718-270-1845
E-mail: HIMROI@downstate.edu

  • Authorized individuals (parents or legal guardians) must complete a HIPAA authorization form with the appropriate required documents and a valid state pictured identification.
  • Parents can also retrieve minors’ documents via the Patient Portal.

To obtain a copy of your X-Ray film, call the SUNY Downstate Health Sciences University Radiology Department at 718-270-3125