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. The Health Information Management department at one hospital cannot release the health records from another hospital. For example, London Health Sciences Centre (LHSC) cannot accept a request to release/copy health records from St. Joseph's Health Care London (SJHC).
Please complete the Authorization for Release of Patient Information form. This form can be printed from our web site or picked up from any Health Information Management department location. To avoid delay, please make sure that all information is completed on the form, ensuring that it is dated and signed by you.
This authorization is valid for 6 months and pertains to the release of information that is specific to treatment received on or before the date signed.
Once this form is completed it can be mailed or dropped off in person at the Health Information Management department, along with:
- Government issues photo identification
- Fee of $33.90. The fee of $33.90 ($30.00 + HST) includes 20 pages, for any pages over 20 you will be charged an additional .25 (+HST) per page. Please be sure to include the fee when mailing or dropping off the completed authorization form. If paying by cash, please ensure you have the exact amount.