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Q-19: Can my spouse get my medical records without my authorization? 

No. An authorization signed by you is required for information to be released to a representative. You would have to give specific consent, as documented on the form, allowing your spouse to pick up the documentation. The only medical records released without authorization are those for continuing care purposes to a physician’s office or healthcare facility or in the event of medical emergency.


Q-20: I am divorced. Can my ex-spouse request my medical information? 

No. An authorization signed by you is required for information released to a representative. You would have to give specific consent for your ex-spouse to retrieve medical information. The only medical records released without authorization are those for continuing care purposes to a physician’s office or healthcare facility or in the event of medical emergency.


Q-21: Can my spouse or representative pick up my medical records? 

Yes. By your request as indicated on the provided form you may allow for pickup of your records by another individual. Please be sure to indicate on the form your representative’s name and relationship. We will need a signed Authorization for Use or Disclosure of Protected Health Information from you to enable us to transmit such information in some cases.


Q-22: How do I get a copy of my birth certificate? 

You obtain records of birth certificates via the Santa Cruz County Recorder’s Office by mail or in person. Please visit the following web site for more information. (http://www.co.santa-cruz.ca.us/rcd/recorders/birth&death/birthcertificate.htm ). Please be aware that birth certificates are available only from the county of your birth.


Q-23: How can I get a correction to an error on a birth certificate? 

Corrections to birth certificates can be made by the Santa Cruz County Recorder’s office. Call (831) 454-2800 for more information.


Q-24: How can I get a copy of a death certificate? 

Death Certificates are obtained from the Santa Cruz County recorder’s office by mail or in person. Please visit the following web site for more information.

For Your Information: Death Certificates may often be obtained from the mortuary if the passing was recent. Please see your mortuary for additional information and instructions.


Q-25: How can I get the medical records of a deceased relative? 

These requests are handled on a case-by-case basis and are subject to Federal and California State Law. Please contact Health Information Management for details on requesting medical records for deceased relatives.


Q-26: I need a list of my treatment dates for my insurance company. Can I get them? 

Yes. A signed authorization is required for the release of this information. Please make sure you list the time frame for which you need the dates released to you. Keep in mind that when we release regular records, your treatment dates will be listed.


Q-27: I am calling from an insurance company and need to confirm the discharge date of a patient recently in the hospital. Can you verify the discharge date for me over the phone? 

No. Please fax a request to the number listed above. Your request must be on company letterhead and include:  

     1. Patient Name 

     2. Patient Date of Birth (DOB) 

     3. The name of the insurance company 

     4. Type-written call back number and fax number

               a. Hand written fax numbers are no longer accepted

     5. The patient’s admission date 


Q-28: I am from a physician’s office and I need copies of reports for our files and/or for billing. How do I get them? 

Automatic distribution of this data is our normal route of communication. Members of the Dominican Hospital Medical Staff also have access to the electronic health record either through Elysium or NFUSE – a remote access tool. Clinicians that are not medical staff members should fax a request to the number listed above. Your request must be on letterhead and include the following information: 

     1. Physician or Group name 

     2. Address 

     3. Type-written telephone and fax number

               a. Hand written fax numbers are no longer accepted. 

     4. Patient Name 

     5. Patient Date of Birth 

     6. Date of Service(s) requested 

     7. Report(s) requested



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Dominican Hospital
1555 Soquel Dr
Santa Cruz, CA 95065
(831) 462-7700