Medical Records -- Release of Information


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Medical Records - Release of Information

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Accessing your medical record


Various circumstances arise that may require Mercy Medical Group release a copy of medical records, i.e a move out of the area or selection of a new provider outside of the Mercy Medical Group. The Release of Information (ROI) Department is available to assist with requests of this nature.

 

Prior to the release of medical information, an authorization is required. Please click here to download, complete and sign the “Authorization for Use or Disclosure of Protected Health Information” form necessary to authorize release of medical information to another entity.

 

Important Information Regarding Release of Information Charges

Please note that per California Health & Safety Code 123110, charges associated with providing copies of medical records are as follows:

 

• Paper copies mailed – to Patient Under 20 pages- No charge; Over 20 pages - Flat rate of $15

• Paper copies mailed – to Provider No charge

• Electronic copy (pdf) - via email No charge

• Electronic copy (pdf) - via flash drive $10.00

 

For additional information regarding release of medical information, please contact the Health Information Services Department/Release of Information Department at 916.363.4040.

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© 2015 Dignity Health

Mercy Medical Group
A service of Dignity Health Medical Foundation
3000 Q Street
Sacramento, CA 95816
(916) 733-3333