Health Information Management - Release of Information

What is a health record?

A health record is comprised of personal information including: your name, gender, address, date of birth and extended health insurance numbers, Health Card Number, information relating to previous health problems, diagnosis, the record of your visits to the hospital and what healthcare we provided to you during those visits.

The Role of Health Information Management

Health Information Management oversees the collection, storage, retention and access to your hospital health record(s). We respect and maintain the confidentiality of your personal health information. Inquiries and requests for a copy of your hospital health record(s) are handled by our Release of Information Department.

Your inquiries and requests are important to us, and every effort will be made to process your request in a timely manner. Response times may vary due to volume of inquiries. We appreciate your patience and understanding.

Accessing a Health Record

Collection, use, access and/or disclosure of personal health information are governed by Ontario law (Personal Health Information Protection Act 2004).

Accessing your personal health record

You have a right, by law, to access your own hospital health record either by (1) requesting a copy or (2) viewing.

Requesting a copy of your personal health record
You can obtain a copy of your personal hospital health record by completing and submitting a Consent to Access/ Disclose Personal Health Information Form, alongside payment, to Health Information Management- Release of Information.

All personal requests for a copy of health record(s) involve payment. The release of information administration and processing fee is $30.00. For all documentation printed exceeding 20 pages, $0.25 will be charged per additional page. Other additional fees may apply.

In the occurrence that an expedited personal request is required, the administration and processing fee is $50.85. For all documentation printed exceeding 20 pages, $0.25 will be charged per additional page. Other additional fees may apply..
Viewing your personal health record
A person can review their own health record at the healthcare facility where they were treated by completing and submitting a Consent to Access/Disclose Personal Information form and payment to Health Information Management. All personal requests for a viewing of health record(s) involve payment of $20.00. This fee allows for up to a 30 minute period of viewing.

Obtaining a copy of the health record of another individual

Consent for the collection, use and/or disclosure of personal health information is obtained from the patient, regardless of age, if the patient is capable of understanding the information presented to them and the impact of consenting or declining. If the patient is not capable, consent is obtained from the patient’s Substitute Decision Maker.

The Substitute Decision Maker may be any of the following:

The individual's (patient's) guardian of the person or guardian of the property.
The individual's attorney for personal care or attorney for property.
The individual's representative appointed by the Consent and Capacity Board.
The individual's spouse or partner.
A child or parent of the individual.
A brother, sister, or any other relative.

In the case of a conflict, the capable patient's decision prevails with respect to consent to collection, use and/or disclosure of their personal health information.

The completed consent and payment is to be submitted, alongside proof of Substitute Decision Maker appointment, to Health Information Management- Release of Information.

All requests for a copy of health record of another individual involve payment. The release of information administration and processing fee is $30.00. For all documentation printed exceeding 20 pages, $0.25 will be charged per additional page. Other additional fees may apply.

In the occurrence that an expedited request is required, the administration and processing fee is $50.85. For all documentation printed exceeding 20 pages, $0.25 will be charged per additional page. Other additional fees may apply.

Obtaining a copy of the health record of a deceased individual

If you are requesting a copy of the hospital record of a patient that is deceased, you must submit proof of your legal signing authority in addition to completing and submitting a Consent to Access/Disclose Personal Information form, and payment, to Health Information Management.

All requests for a copy of health record of a deceased individual involve payment. The release of information administration and processing fee is $30.00. For all documentation printed exceeding 20 pages, $0.25 will be charged per additional page. Other additional fees may apply.

In the occurrence that an expedited request is required, the administration and processing fee is $50.85. For all documentation printed exceeding 20 pages, $0.25 will be charged per additional page. Other additional fees may apply.

Proof of Legal Signing Authority involves provision of one of the following to Health Information Management:

a copy of the deceased person's Will naming you as the Executor or,
in the absence of a Will, a letter notarized by a lawyer to confirm your legal signing authority.

Obtaining a copy of your health record for a third party

You can request that a copy of your personal health record be released to a lawyer, insurance company, or any other third-party specified by completing and submitting a Consent to Access/Disclose Personal Information form, and payment, to Health Information Management.

All requests for a copy of health record for a third party involve payment. The release of information administration and processing fee charged to the third party requester is $33.90. For all documentation printed exceeding 20 pages, $0.25 will be charged per additional page. Other additional fees may apply.

In the occurrence that an expedited request is required, the administration and processing fee charged to the third party requester is $50.85. For all documentation printed exceeding 20 pages, $0.25 will be charged per additional page. Other additional fees may apply.

Consent to Access/Disclose Personal Health Information

To process any of the above stated requests, please complete the Consent to Access/Disclose Personal Health Information form. This form can be printed or picked up at the Health Information Office at Hôtel-Dieu Grace Healthcare- 2nd Floor Casgrain (Room #2429).

Please be advised that for your protection, a copy of a health record will not be released to third parties without your written authorization. Health information cannot be released over the telephone.

To avoid delay, please make sure that all information is completed on the form, and ensure that it is signed and dated.

This form can be mailed or dropped off in person. Please mail or deliver completed consent forms and payment to Health Information Management. To expedite your request, the form may be faxed to the Release of Information Department at (519) 257-5107.

This authorization is valid for six months and pertains to the release of information that is specific to treatment received on or before the date signed.

Contact Information