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Medical Records


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Q-06: Can I fax or electronically submit the request for release of information? 

No. At this time we are unable to fulfill requests submitted electronically. This is subject to change as we are moving toward a more electronic environment.


Q-07: How long does it take to receive health information? 

We will make every effort to fulfill your request in a reasonable amount of time; in some cases if the request is small and easily obtainable we will release your records to you the same day. Charts that are in storage may take require additional time. A request for an electronic copy of your medical record may be available one (1) to three (3) business days from the time your request is received.


Q-08: Will I need to present a form of identification? 

Yes, we request a picture ID when you drop off the form and/or when you pick up the records after they are copied.

Acceptable forms of identification include, but are not limited to: 

     1. Driver’s License 

     2. Government-issued identification 

     3. Passport 

     4. Military identification


Q-09: Can someone act on the patient’s behalf?  

Yes. Legal documentation is required such as a Medical Power of Attorney, Executor of Estate, Conservator, Legal Guardian, etc. Please fill out the “Patient’s Request for Access to Protected Health Information” form and be prepared to produce copies of the legal documentation which will be retained in patient’s medical record. 


Q-10: Can you give me my medical information over the phone? 

No. Due to privacy and confidentiality concerns in conjunction with requirements of the Health Information Portability and Accountability Act (HIPAA), we are unable to convey health information by phone. This is mainly due to the inability to confirm identity and we are not clinical personnel able to explain test results with you.

An authorization is not needed to send copies of your records to the physician that is overseeing your care in the hospital or your primary care physician (family physician). You may be able to obtain specific information over the phone from your physician who has a relationship with you and is comfortable confirming your identify by phone. This depends on the physician’s policy and may not be true of all offices. 


Q-11: Does the Release of Information department handle all medical information releases? 

In most cases ROI directly handles the release of health information for medical records. Your radiology films and billing information are handled by those respective departments. Please call Diagnostic Imaging or Patient Accounting at the numbers listed above.


Q-12: Do you accept faxed authorization from other facilities? 

Yes. We accept authorization faxed with a cover sheet from other facilities that allow us to verify their identity in order to fax back documentation or medical records for continuing care. The same process is used for physician offices.


Q-13: Why do I have to sign an authorization to obtain 'my information'? 

It allows for a formal method of obtaining consent. The authorization serves the following purposes: 

     1. It serves as documentation for what information has been requested. 

     2. It allows for proof of consent to the release of information to yourself or your representative. 

     3. It allows for proof of consent to the release of information to physicians or other facilities, if applicable. 

     4. It allows for tracking of what has been released in the past.

For your information: Medical information located in the legal health record, in all formats, is property of the hospital. You have full access to this record at all times, except where prohibited by law. Any exceptions, due to emergent situations, are handled by management on a case-by-case basis.


Q-14: Do I have to pay for copies of my medical information? 

The majority of the personal requests for information will not require payment as Dominican Hospital offers this service as a courtesy to our patients.


Q-15: Does my family physician get copies of my medical records? 

Your local family physician is automatically distributed a pertinent set of your medical information for billing and continuing care purposes.

For your Information: Your local family physician has access to our electronic health record and may access copies directly from there. Non-local, or out of state physicians need only fax a request to our department. If you wish to initiate this exchange of information yourself please fill out the form, “Authorization for Use or Disclosure of Protected Health Information,” and fax, mail, or bring to our office. Please be aware that your records may be sent to another hospital without authorization, in the event of an emergency situation.

Q-16: Can a parent or legal guardian sign a release for records for a patient that is 18 years old? 

No. The age of majority in California is 18. Therefore, in order for us to release the information to you we would need a signed authorization from the patient.


Q-17: Can a parent or legal guardian sign a release for record for a patient that is under 18 years old? 

Most of the time. The age of majority in California is 18. Unless the patient has documentation proving that s/he has been emancipated from the adult requesting the record, you are able to sign for the release of information.

For your information: In certain circumstances for a minor we would not release information to the parent without the consent of the minor. For example: if the minor's physical safety or psychological well being would be harmed as a result of the release to the parent or when access would be detrimental to the provider’s professional relationship with the minor. In such a case we would ask that the minor sign to release the records to the parent. This is handled on a case-by-case basis.


Q-18: Can you fax my medical information? 

Sometimes. Typically speaking medical records are only faxed for immediate patient care purposes to physician offices or healthcare facilities. Faxing information imposes a risk to confidentiality and often lowers the quality of the requested information. While we will make every effort to fulfill the request to fax your data, we may deny this request if we are unable to reasonably verify your fax number. Please note that medical records stored offsite may take time to retrieve.
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Dominican Hospital
1555 Soquel Dr
Santa Cruz, CA 95065
(831) 462-7700