Release of Medical Record Information

365体育投注 Health allows patients to request copies of their medical records via mail, fax, MyChart, or in person at any 365体育投注 Health hospital location.


Patient Requesters

To request a copy of your medical record:

MyChart

365体育投注 Health patients can now request copies of their medical records using the electronic request form within their 365体育投注 MyChart account.

If you do not yet have a MyChart account, you can easily create one on the  by clicking the orange Sign Up Now button.

Records will be delivered electronically back to your MyChart. Our goal for delivery is within 3 business days, but due to volume of requests received may take up to 14 business days. 

 
  • Once logged into MyChart, click the Health icon in the menu along the top of the screen.
  • Under Medical Tools, select Document Center, then select Request/Download My Medical Record.
     

Mail or Fax

1.) Download and complete the Authorization for Release of Information form. 

2.) Mail or fax the form to our centralized HIM location:

365体育投注 Hospital Randallia
Attn: HIM Release of Information
2200 Randallia Dr.
Fort Wayne, IN 46805
FAX: 260-373-3781

Please allow 7-14 business days for completion of a medical records request. Please note that it can take up to 30 days as allowed by law.
 

Visit a 365体育投注 Health location

Come into any of the following 365体育投注 Health locations to fill out your request in person.

Release of Information office hours are Monday through Friday, 8:30 a.m. - 4:30 p.m.

Depending on size of your request, you may be able to wait for copies. We must have a completed authorization in order to begin processing your request. If your request exceeds 100 pages, it will be placed on a CD for $6.50 per the HITECH Act for the electronic portion of your records. There may be an additional charge for any paper copies.
 

For 365体育投注 Behavioral Health patients

To request a copy of your behavioral health record:

1.) Download and complete the Behavioral Health Authorization for Release of Information form.

2.) Mail or fax the form to our centralized HIM location:

365体育投注 Hospital Randallia 
Attn: HIM Release of Information
2200 Randallia Dr.
Fort Wayne, IN 46805
FAX: 260-373-3781

Please note: Behavorial health records requests must be approved by treating provider prior to release. Your records will be mailed to you after your approval is obtained.


Other Requesters

For healthcare provider requests

1.) Fax your authorization or facility's coversheet/letterhead to 260-373-3781. Please include patient's identifiers and description of information you are seeking.

2.) Call 260-373-3780 to talk a ROI tech directly.
 

For all other requesters (attorneys, insurance, 3rd party services, etc.)

Please note: We reserve our fax line for continuation of care purposes due to high volume of requests. If you are not a 365体育投注 patient and requesting medical records from 365体育投注 Health, please send your requests one of the following ways:

1.) Mail (preferred)

365体育投注 Hospital Randallia
Attn: HIM Release of Information
2200 Randallia Dr.
Fort Wayne, IN 46805

2.) Email your request letters with authorization to ROIRequest@parkview.com

Note: Email transactions are not encrypted and may be viewed by a third party.

Any faxed requests without prior approval will be returned.

Please allow 7-14 business days for completion of a medical records request. Please note that it can take up to 30 days as allowed by law.


Charges for Medical Records

State and federal laws permit fees to be charged for copies of medical records. 


Questions

If you have questions about the process for requesting Medical Records, please contact HIM Release of Information directly at 260-373-3780.


Chart Correction Requests

365体育投注 Health patients can now request chart corrections via MyChart or in person at any 365体育投注 Health hospital location. Click here for more information.