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).
Please callone of our officesto make an appointment to find out if you qualify.
They are available from Monday to Saturday, from 8:00 am to 9:00 pm eastern time, and Sunday from 10:30 am to 7:00 pm eastern time. Featuring a monthly dose of information and inspiration for living well. Yes. It gives you access to most of your medical records on your desktop computer, laptop, tablet or smartphone 24 hours a day. Authorization Form to Disclose PHI. Medical questions should be directed to your provider. Needs Assessment & Implementation Strategy 2021. 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. Community Health Castleton and Community Health Rutland both offerExpress Care for adults and children, for sick visits and minor injuries. Copyright 2023, Intermountain Healthcare, All rights reserved. (801) 429-8000. patientconcerns@reverehealth.com. Patients can request their records through MyChart. The mailing address for Brandon Regional Hospital is 119 Oakfield Drive, , Brandon, Florida - 33511-5779 (mailing address contact number - --). Return the completed form with one of the following options: 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. Fax No. For assistance, call (866) 463-7272. You can also download the MyHealthONE app in the App Store and on Google Play to access your health information. Paper records may be charged up to $0.25 per page. 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. Community Health Brandon, Specialty: Diabetes Management, Family Medicine We also understand the importance of giving you easy access to your medical records and keeping those records private. If a patient wants to look at their medical record or get copies of their record, they may submit a written request to the Health Information Department. 5.) MyHealthOne consolidates many common tasks into one secure, easy-to-use online patient portal. Laboratory/Blood Draw Stations:For patients of Community Health, Laboratory/Blood Draw StationMonday-Friday8:00am 11:30am, Please note: draw stations are closed to observe the following holidays:New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day. You may fax this information to (601) 824-8627 or mail your request to: All Rights Reserved. For questions contact the health information office. 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 --. Fill out this form to authorize the release of your health information. Sit back and relax while we do the work. Download, print and complete the authorization form. Copyright 2023, Intermountain Healthcare, All rights reserved. Get lab results, view medical records, and message providers with our patient portal. Authorization for Release of Medical Information - Spanish. If parents, adult children, or other caretakers would benefit from access to their family members records. About Us Contact Us or state I.D.). DSH-Napa: Department of State Hospitals - Napa 2100 Napa-Vallejo Highway Napa, CA 94558-6293 Medical records requests will be filled within 30 days of your request. There is no need to go to or contact the healthcare facility from which you requested your records in order to make payment. 2023 County Office. 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. This form must be completed for all releases involving the records of a deceased patient. If this is an emergency please go to the nearest emergency room or call 911. For all other concerns, you may call (601) 824-8307 and someone can assist you during our business hours, Monday - Friday, 8 a.m. to 4:30 p.m. You may visit the medical record pick-up window at 7 of our hospitals or mail or fax your request. Simply complete an authorization release of your records at the facility, and HealthPort will handle the rest. There will be a fee for providing copies of your medical records. You may send your request in the following ways: Fax: (844) 481-0298. View wait times and save your place in line at an Intermountain InstaCare location near you. Attention: CLAIMS, Phone No.
Contact us at (813) 660-6000. Here's How, How Long Do You Have to Keep Medical Records? Fill out the Request Submission Form below and attach a completed PDF version of the Authorization for Release of Health Information Form. To remit payment by check, please include the bottom portion of the enclosed invoice and send to the address listed. We look forward to taking care of the medical and dental needs for you and your family, something weve done since 2004. Location: : 202-619-2922. Requests should be sent from your insurance company, attorney, or Disability Determination Service and mailed to the address below. ">Behavioral Health Caregiver Support Group, 7 Healthy Habits for the New Year and Beyond, please print and complete this authorization form. Trying to access your medical recordscan be a confusing and time-consuming process. Start here for answers to billing questions, help with enrollment, insurance, and more. Provider Profile Details: NPI Number Details: Suggest Listing
Admitting/registration (after 5:00pm and weekends): (813) 916-1472, Billing& patient accounts: (800) 733-0429, Class and event registration: (813) 653-1065, Diagnostic and rehab center: (813) 916-1727, Environmental services/lost and found: (813) 916-0665, Heart and Vascular Department: (813) 916-0661, Medical staff coordinator: (813) 916-0244, Patient account customer service: (800) 733-0429, Patient estimation assistance: (800) 617-7044, Patient information/rooms: (813) 681-5551.
If needed, download and complete the Authorization for Release of Health Information Form. Otherwise, you may use Intermountain Healthcare. Location: They can be reached at 1-855-422-6625. Physicians & Hospital Requests for Medical Records Requests for medical records regarding continuation of care are sent directly to the physician at no cost. Copyright 1999-2022 C-HCA, Inc.; All rights reserved.
All Rights Reserved. brandon hospital medical records phone number. Name Brandon Regional Hospital Suggest Edit Address 119 Oakfield Drive Brandon , Florida , 33511 Phone 813-681-5551 Website brandonhospital.com Brandon Regional Hospital Details Type General Acute Care Hospital NAICS Description Appointments. Purpose of Disclosure: This is somewhat flexible, but examples we get are: personal records; transfer of care; going to specialist; etc. Here's How, Can You Request Mercy Gilbert Medical Records? Lucky for you, DoNotPay created an easy-to-use product, so you can access your medical records from Brandon Regional Hospital. Mail: PO Box . * Note: Federal law prohibits University of Utah Health from releasing substance abuse treatment records without a patient authorization directing us to release such records, or a specific court order. Free, convenient online check-in services. The sliding scales are based on your income and family size. County Office is not affiliated with any government agency. Authorization for Release of Health Information Form. Tell Us About Your Experience; Get help with a billing issue; Need help with financial assistance; Website feedback; Contact Intermountain; 01/01/3000 or 10/14/2015. If the patient completes the form and send their request by mail, email or FAX, the form must be notarized to verify that the signature belongs to the patient.
. Intermountain Healthcare understands the importance and sensitivity of your health information. 2023 Revere Health. Phone: 660.827.9590 Fax: 660.827.6804 Mail: Bothwell Regional Health Center Attn: Health Information Management 601 E 14th St Sedalia, MO 65301 Request Forms To speed up the request process, Bothwell asks the appropriate following form be filled out and turned in with your request. As residents of the communities we serve, they have the unique ability to provide the leadership necessary to make our organization a success. Still not finding what you are looking for? Please do not attempt to contact HealthPort to request your records. Phone: 801-581-2353 Login to MyChart. If the patient comes in person, they must bring government-issued, picture identification, such as a drivers license, passport, military card. We operate Primary Care Medical Offices in Rutland, Brandon, Castleton, Shoreham and West Pawlet, Vermont. Bothwell Regional Health Center maintains documentation of your health care in the form of a medical record. Release of information must comply with state and federal guidelines.
Access your medical information on demand. Search for Intermountain hospitals and clinics in Utah and Idaho to meet your medical needs, Our skilled physicians provide high-quality care across a variety of specialties. 119 Oakfield Dr, Brandon, FL 33511, USA (813) 681-5551 Website Patient Portal Order Your Records Emergency? If you only want a specific time, you must put a date in the expiration date location. For immediate continuity of care, your healthcare provider can request records. Imaging services For the convenience of our guests, on-site parking and wifi are available. Records delivered by email will be received within 1-2 Business days after processing. Or,if you prefer to do it on your own, you can follow our how-to guide below. Records delivered by mail will be shipped within 5-7 Business days after processing. Attorney Requests for Medical Records SMHCS only accepts subpoenas via hand-served or certified mail.
Fax requests should only be made in urgent situations or from other physicians. The charges for the copies you request are typically regulated by each state. This is substantially cheaper than paper requests. (if you want to allow others access to your records in case of emergency). Find the physical address or fax number of the Medical Records Department that you need to contact to request your medical records. CountyOffice.org does not provide consumer reports and is not a consumer reporting agency as defined by the Fair Credit Reporting Act (FCRA). Otherwise click here to contact us online, or provide feedback on your recent experience. The authorization form must be signed and dated. HealthPort accepts Visa, MasterCard, American Express and Discover. Copyright 1999-2022 C-HCA, Inc.; All rights reserved. To obtain medical records for Boca Raton Regional Hospital, Bethesda West, and Bethesda East. 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. Brandon, MS 39042 To get the status of a request, call 1-800-560-3800. 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: Billing Records: If you are requesting a copy of billing records, you must contact Patient Financial Services at 786-596-6507. Submit all mail requests to their address. Customer Service Department Monday through Friday from 9 a.m. to 4:30 p.m. at 786-596-6507 or toll free at 1-800-235-0065. We are here to help you find the answers you need. Express Care is open 7 days, 8:00am 8:00pm. Review your medical records online in a safe, secure environment.
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. If this is an emergency please go to the nearest emergency room or call 911. It can take 5-7 days for requests to be processed. Please contact health information if you have questions regarding the release of patient information. Posted on May 23, 2022 by 0 The Hospital provides emergency care for injuries, sudden illnesses, and severe illnesses in Brandon. 330 Independence Avenue, S.W., Room 5362 For assistance, call (866) 463-7272. Offline requests may be made in the following ways: To speed up the request process, Bothwell asks the appropriate following form be filled out and turned in with your request. 813-971-6000 Florida Hospital Tampa. MyHealth One has a dedicated customer service line for Brandon Regional Hospital patients. 2022 Community Health Centers of the Rutland Region. 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. We cannot accept faxes and email requests. Community Health offers a full range of medical, dental and behavioral health services including preventative care, well child care, acute care and management of chronic illness. (e.g., driver's license, military I.D. And that's it! HealthPort is the premier provider of health information services and solutions. When you request your medical records, you will receive a copy of the original records located in the medical facility. 2023 Bothwell Regional Health Center. Close; Community Health Your Health, . brandon hospital medical records phone numbercandytuft companion plants. There is no fee to release records to doctors or health care facilities. Find 6 Hospitals within 12.1 miles of Brandon Regional Hospital. Urgent requests, records for your physician, Non-patient requests (insurance, attorney, disability and third party requests), Authorization for Release of Medical Information, Autorizacin para la divulgacin de informacin mdica. Salt Lake City, Utah Serving uninsured and underinsured patients has always been a cornerstone of Community Health. Address and Phone Number for Brandon Regional Hospital, a Hospital, at Oakfield Drive, Brandon FL. Select "Health". The Community Health Board of Directors is a dedicated group of community members, the majority of whom are also our patients. Third party advertisements support hosting, listing verification, updates, and site maintenance. Tampa SSC See 42 CFR Part 2. HIPAA law requires an actual date, e.g.
1. Patients can request their records through MyChart. Nashville, TN 37239 -2409. Medical Records Fax: 801-581-2177. delivered right to you - no need to go and pick them up. Retrieving medical records by mail or email can be a long and confusing process. 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? 1055 North 500 West Provo, UT 84604 Your request must be sent directly to the medical facility. To get the status of a request, call 1-800-560-3800. You can reach Brandon Regional Hospital medical recordsthrough: Confusion with MyHealth One has led many to frustration when trying to access their medical records. using start date to final date you would like released. The healthcare facility will not be able to assist you with your invoice payment for these services. If you choose to request your records from this facility, please know that HealthPort will be processing and fulfilling your request. MyHealth One also has an app available on Android and Apple. Find 10 external resources related to Brandon Regional Hospital. Nearly every clinic and the hospital has its own process and portals for retrieving medical records. After your request is received, we will send you an invoice for the cost of the records you requested, if applicable.
'all' on both [to and from] lines; or you may choose a time frame For questions regarding obtaining medical record copies, or to obtain the status of your request call (844) 481-0278. There will be a fee for providing copies of your medical records. Otherwise, if left blank, the authorization will be valid for one year. A photo ID is required. Privacy Policy Patient Protections Against Surprise Billing, ColumnFriendlyUrl: The SystemName (classes-events) does not exist or is not a module. Still not finding what you are looking for? Health Information Management Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. See below for mailing and fax information. Look up medical records on DoNotPays website. Skip to Intermountain Healthcare company wide navigation, Skip to Intermountain Healthcare company wide footer navigation. Fax: 757-648-8534. For assistance, call (866) 463-7272. Find information about your responsibilities as a patient. 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.
A copy of a legal photo ID must be included in the request. Medical records are maintained in either electronic or paper formats depending on the date and location of the services provided. Affadavit for Deceased PatientsThis form must be completed for all releases involving the records of a deceased patient. 435-207-4651. Brandon Hospital welcomes your suggestions and will answer any questions you may have about our services. Skip to Intermountain Healthcare company wide navigation, Skip to Intermountain Healthcare company wide footer navigation. Get care for low-level urgent conditions through a video chat with a provider, 24/7, on your computer or mobile device.Learn More. Be prepared to answer thorough questions, including patient details, the purpose of disclosure, dates of treatment, type of records, etc. 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. Who you would like to authorize to disclose your records: e.g. Looking for Cox Medical Center Branson in Branson, MO? 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 Intermountain Healthcare is a Utah-based, not-for-profit system of 33 hospitals (includes "virtual" hospital), a Medical Group with more than 3,800 physicians and advanced practice clinicians at about 385 clinics, a health plans division called SelectHealth, and other health services. To receive a copy of your medical records, please print and complete this authorization form. This web inquiry page cannot be used for questions regarding these health related issues.