1/11/2024 0 Comments Locate pediatric medical records![]() ![]() Follow the instructions on the left side of the form to guide you in providing the type of information needed.Spanish: Autorización para Revelar y Divulgar Información del Paciente (PDF).English: Authorization to Release and Disclose Patient Information (PDF).This form is standard across IU Health and can be used to request copies of your child’s medical records at any of our facilities. Download and print the Authorization to Release and Disclose Patient Information form.There is a three-step process for requesting copies of your child’s medical records from IU Health. How do I request my child’s paper medical records? Once the patient’s account is established, the patient may then share their health record with others, if they choose to do so.įor assistance with a My IU Health patient portal account, both team members and patients can contact the My IU Health Patient Portal Support team at 317.963.1661 from 8 am to 4:30 pm Monday – Friday (excluding major holidays).Both the parent or guardian and child will need to be present on the call in order to complete the consent form over the phone. If you are unable to have an in-person office visit, you may call My IU Health Patient Portal Support at 317.963.1661 for assistance. Both the patient and parent or guardian must be present in the office to establish this access.The Health Services Parent/Guardian Consent for Minor Patient Online Access form must be signed and stored in the patient’s medical record. Patients between the ages of 14 and 17 can create their own My IU Health account with the approval of a parent or guardian.On the patient’s 14th birthday, the parent or guardian’s access to the patient’s health record is automatically removed.Note: Registering for an account does not require the parent or guardian to be a patient of IU Health. If a parent or guardian has their own account, they can request access during a patient’s office visit or by calling My IU Health Patient Portal Support.If a parent or guardian does not have their own My IU Health account, they can request access during a patient’s office visit.The child’s health record is only accessible by a parent or guardian. Patients under the age of 14 may not create their own My IU Health account.Please take note of the following differences to the normal sign-up process depending on the age of your child. IU Health and Riley Children's Health takes particular care to ensure the safety and security of our pediatric patients. With a My IU Health account, you can access an electronic version of your child's medical records immediately. View our frequently asked questions below.įor more information, contact Health Information Management at or call 33 between 7-4 p.m.Accessing Medical Records with My IU Health If the patient's name in the medical record or M圜hart does not match their current legal name, you may provide any of these documents to request a name change: birth certificate, court order, divorce decree, driver's license, finalized decree of adoption, marriage certificate, Medicaid insurance card, passport or social security card. ![]() To ensure we have one patient per medical record, we require legal documentation to prove a name change in our system or correct any name discrepancies in the patient’s record. Due to the timing of some patient registrations, we may have a name on file that has never been the legal name of you or your child. The policy of Akron Children's Hospital is to maintain the first-registered patient name in the medical record until we receive legal documentation that allows a name change. Healthcare professionals may fax signed releases to: 33Ĭopies for doctors and other care providers are free, otherwise customary charges will apply.Ĭall Health Information Management at 33 for more information. Print the blank form, complete by hand and sign.Ĭomplete the fillable (pdf) form using the required information above and sign using an e-signature (must include a photocopy of a government issued ID for proof), or print and hand sign. your name, address, phone number and relationship to the patient.To request a copy of your medical record or your child’s record for personal use, please choose an option below. Be sure to include: ![]()
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