Health Records

 

We share your personal health information with your health care providers. If you do not want us to share your information, please let us know.

 

The office is not open to the public without an appointment. Health Records may be requested through the website, email, or phone. Arrangements can be made if these options are not available to you. Kindly note that Health Records cannot be provided via email at this time. Secure Electronic File Transfer can be arranged when necessary.

 

Inquiries to Health Records will be answered Monday through Friday between 0900 – 1630 hours, excluding statutory holidays. Please note that on-site appointment requests can only be scheduled on Tuesdays and Wednesdays, during the same hours.  See 'Contact' below for more information.

 

Release of information staff

Welcome to the Request My Records section. Here you will find the process, necessary links and payment instructions to get your health records.

 

Custodial parents of children under 16 years of age can request records on their child’s behalf; please note that consent from both parents may be required. If you cannot complete the online Request and Authorization form to access your medical records, you or the substitute decision maker may contact the Release of Information Office by phone, email, fax and mail for assistance. 

 

Requests will not be processed without a completed Request and Authorization form, and verification of ID. Requests are processed in order of receipt. Please note, requests will take approximately 3-15 business days to be processed, although we have up to 30 days to complete as per IPC and PHIPA. A processing fee may apply - se Fee Schedule in this section. 

 

Health information is retained for the period required by law. If you were an adult (18 years according to the legislation) at the time of treatment, the information is retained ten (10) years past the date of treatment. In the case of a child under the age of 18 years, the information will be retained for a period of twenty-eight (28) years. Radiology films are retained for five years. Records beyond this retention period are destroyed.

 

Important information

  • There is $40 flat fee to process your request. There is no cost to transfer medical records to a health care provider (e.g., specialist, family doctor, etc.). 
  • Health records will be sent to you in a PDF format through a secure file transfer.
  • Health records cannot be sent by email.
  • Images, such as x-rays, cannot be included in this request. If you need images, these can be obtained through a different process using Pocket Health or by having a CD with the images mailed to you separately via Canada Post. Learn more here. 

Before you start, please have ready:

  • A copy or photo of your Government issued ID
  • Proof of Authorization if you are the Substitute Decision maker (SDM)

Read through the process for requesting your records

  1. You fill out and submit your request through an on-line request form. You include your Identification, and if you are the SDM you also include a Proof of Authorization
  2. Release of Information receives the request and makes an assessment
  3. If request can be completed it is added to the queue. If the request cannot be processed; you will be contacted.
  4. When the request is processed, your records are compiled and an invoice is issued to you
  5. You are notified via email to make an online payment using the invoice number that was sent to you.
  6. After the payment is processed, Release of Information is notified of the payment. This may take 2-3 business days.
  7. Your records are released using Secure File Transfer (see below)

Fill out and submit the form:

To make an online payment

  • Go to Cambridge Memorial Hospital (cmh.org)
  • Click the ‘Pay your Bill’ link in the header 
  • Under Payment Options – Click on ‘Click here’ to pay online
  • Click on the “I Agree and Continue to Payment”
  • Enter the required Information:
    • First Name, Last Name, Address, City, Province, Postal Code, Country, Email address & Phone Number
  • Enter the payment amount. Enter the Patient Account #, which will be the MR-XXX-XX number provided to you from Release of Information.
  • Enter the code displayed, then submit.
  • Enter Card Holder Name
  • Enter Credit Card Number, Expiry Date, Card Security Number, then submit.

To access records through Secure File Transfer

  1. Open email received from “CMH-WebFTP” Subject Line will say “You’ve been added to a workspace”
  2. In the email it will have a “View Folder” button, click on button.
  3. This will take you to a log-in page - create a username & password on this page
    1. The username can be your email
    2. The password must:
      1. Contain at least 6 characters
      2. Contain at least one Uppercase letter, One Lowercase letter and One numeric character
      3. Not contain characters form the user-name
      4. Not contain more than 3 repeating characters
      5. Password cannot contain a recognizable word. For example, change "Cheese" to "Ch33s3"  or "Link" to "L1nk"
      6. If you receive an error message, try resetting your password to CmhRo1! 

Patients can now access their health records through ConnectMyHealth. ConnectMyHealth is a digital health solution that provides you with an online, single access channel to view your health records from participating hospitals, including CMH, in Ontario Health West Region (Southwestern Ontario)

 

If this is of interest to you, create an account with ConnectMyHealth to gain free access to your records. Learn more about ConnectMyHealth here

 

If you need access to your images (i.e., x-rays, ultrasounds, etc.) and you do not need a report, you can access these through PocketHealth.  See the 'Accessing Medical Imaging'  section on this page for more information. 

 

For patients that used MyChart, this service is no longer registering patients in Southwestern Ontario. 

 

 

If you require imaging only and no reports for follow up care by your Specialist or Surgeon, please contact our Diagnostic Imaging department.

 

You can also access your imaging through PocketHealth - kindly note these are for images only with no access to reports. You may also make an in-department request by visiting CMH's Diagnostic Imaging Department, Monday through Friday 8:00 am – 5:00 pm to request your images on CD.

If you require a “Proof of” letter, please provide the following information to Release of Information:
 

  • Proof of Birth Letter for Service Canada (Only if not provided by physicians, midwife or birthing unit)
    Mothers full name and Date of Birth
    Fathers full name
    Child’s full name and Date of Birth
    Current address
  • Proof of Birth (School, Athletic Application, etc.)
    Mothers full name and Date of Birth Child’s full name and Date of Birth
    Current Address
  • Proof of Death Letter
    Patient full name and Date of Birth
  • Proof of Admission/Attendance
    Patient full name and date of birth Date range required (can be approx.)

You will be notified when records are available to pick up. Kindly note that CMH does not issue birth or death certificates. See sections below for contact information. 

 

There is a flat fee of $40.00 for “Proof of” Letters. See the 'Fee Schedule' in this section for more information 

 

You may pay over the phone by credit card if you opt to have these documents sent through Canada Post.

 

 

This section provides information on how to access health records for a deceased person or a person that is incapable of making decisions about their own care. 

 

Deceased Patients - To release personal health information of a deceased patient, a signed CMH authorization form is required from the executor(s) of the estate (with proof, copy of first page where it names the executor(s) and last page where the patient/deceased signed the Will). If no Will exists, a Certificate of Appointment of Estate Trustee or an Administrator of Estate letter is required. Please contact Release of Information for more information on these items.

 

Power of Attorney (POA) – To release health information to the POA for personal care, a signed CMH authorization form is required along with the POA document.

 

Substitute Decision Maker (SDM) – To release health information to the SDM, a signed CMH authorization form is required along with proof of SDM. 

 

More information about Substitute Decision Makers & Powers of Attorney for Personal Care and the Hierarchy of Substitute Decision Makers (SDMs) based on the Health Care Consent Act s.20.

There is an administrative fee for copies of your record based on the current fee schedule. An administrative flat fee of $40.00 shall apply to all requestors, the records will be provided as a pdf file using Secure File Transfer or alternate means as required.

 

Paper copies of records will be charged a $30.00 processing fee for pages 1 to 20. After the first 20 pages, any additional pages will cost $0.25 cents per page.

 

Please note: There is no fee to release patient information to other health care facilities or physicians, for continuity of patient care.

 

As of April 10, 2023

REQUESTER/TYPE

CHARGE

 

Basic PHI request by patient for NON medical reasons

(Including Administrative Letters)

$30.00

Each page over 20 is $0.25ea

Electronic copy $40.00 processing fee 

Diagnostic CD including medical reports for NON medical reasons

 

$40.00 total

Diagnostic CD without medical reports for NON medical reasons

 

$10.00 total

Time of Birth

 

No Charge to Patient

 

Visit History

No Charge to Patient

Proof of Birth Letter

Proof of Birth Letter for Service Ontario

$40.00/ea

Fax records to Healthcare Provider for continuing care

No Charge to Patient

 

Request by Law Offices, Insurance Company, Medchart, Best Doctors

 

 

                                                           $30.00

Each page over 20 is $0.25ea

Electronic copy $40.00 (flat rate)

Plus 13% HST

Diagnostic imaging CD $10.00ea

Courier $15.00ea pkg

Supervising an individual’s examination of an original record

$6.75/15 mins

Worker’s Compensation Board

$48.15 (flat rate)

College of Physicians and Surgeons

College of Nurses of Ontario

Electronic copy $40.00 (flat rate)

Plus 13% HST

Courier $15.00ea pkg

 

Expediting Fee

**FLAT FEE OF $50.00 ADDED TO ABOVE COSTS, BEFORE TAXES IF APPLICABLE, TO EXPEDITE REQUEST**

CMH does not remove health records in their entirety, but rather, it provide patients with a means to request corrections to be made. 

 

In order to make a correction to your record, fill out the Request to Correct Personal Health Information form clearly outlining what you are requesting to have changed. The form can be mailed in, emailed, or faxed. Once received, the HIM (Health Information Management) manager will notify the health care provider of your correction request. HIM has a period of 30 days to respond to your request at which time you will be notified whether the change has been made or not.

 

Under the Personal Health Information Protection Act (PHIPA), the hospital is not required to make corrections to information that is irrelevant to your care or information that consists of a professional opinion or observation that a health care provider has made in good faith about you. Under PHIPA, you have the right to prepare a concise Statement of Disagreement that sets out the corrections that CMH has refused to make. CMH will attach this Statement as part of the records.

 

Please note CMH does not correct external documentation – patients will need to contact the organization directly. Contact the HIM manager if you have any further questions or concerns about corrections.

You may update or correct your name, address, phone number, family doctor and other contact information through the registration process at your next appointment or by contacting Release of Information:

 

Email: ReleaseofInfo@cmh.org
Fax# 519-740-4958 
Phone# 519-621-2333 ext. 1382

Circle of care requests to Release of Information may be made Monday to Friday, between 9:00 am to 4:30 pm (excluding Stat holidays). You may submit the Circle of Care Request Form by:
 

  • Fax: These are completed first in order of Fax received – Release of Information Fax# 519-740-4958
  • Email: Completed within 24-48hrs of Email received – Release of Information Email ReleaseofInfo@cmh.org
  • Phone: Completed within 24-48hrs of Phone call received – 519-621-2333 ext. 1382 (please note due to the high volume of calls and requests, you may have to leave a voice message. Please include patient name, date of birth or health card number, name of office or healthcare provider and phone and fax numbers.)

Circle of care requests made outside of Release of Information normal operating hours should be faxed to 519-740-4921

 

**Please note: Health Records cannot be provided via email at this time. Secure Electronic File Transfer can be arranged if necessary.**

A completed request form, including patient consent, can be emailed to: releaseofinfo@cmh.org

 

Records Request Form - Police

 

Please note:

Records CANNOT be provided via email at this time. We can provide records using secure Electronic File Transfer.

Contact Privacy Office: Patient Privacy | Cambridge Memorial Hospital (cmh.org)
FOI information: Freedom of Information (FIPPA) | Cambridge Memorial Hospital (cmh.org)
Send request to: FOI@cmh.org

 

Request to Lock Personal Health Information (Lock-box)
Request to Unlock Personal Health Information (Lock-box)
Withdraw or Withhold Consent for Collection, Use or Disclosure of Personal Health Information

The hospital does not issue/copy death certificates. To obtain a death certificate, contact Service Ontario at 1 800 461 2156 or through the Service Ontario website.

The hospital does not issue birth certificates or keep the birth registrations on file. To obtain a birth certificate, contact Service Ontario at 1 800 461 2156 or visit the Service Ontario website.

Map showing location of Release of Information office

Visitor parking is assigned to Parking Lot #2 and Parking Lot #4. When calling to make an appointment, please ask the clerk which parking lot is closest to the location of your visit.  

Phone# 519-621-2333 Ext. 1382
Fax# 519-740-4958

Email ReleaseofInfo@cmh.org

Inquiries to Health Records will be answered Monday - Friday between 0900 – 1630 hours, excluding statutory holidays. On-site appointment requests can only be scheduled on Tuesdays and Wednesdays, during the same hours.  

Our office location is Wing C, Level 0, Room #228

Have you visited CMH?

It is your right as a patient to determine when, how, and to what extent you share your personal health information about yourself with others.

Protecting your information after it is collected. This means that the staff members, physicians and volunteers must not talk about or disclose your personal health information to anyone other than you, your substitute decision maker where applicable, or other staff or health care members that have a need to know.

Physically and technologically protecting your information after it is collected. This means that staff members, physicians and volunteers will physically protect your information. For instance we lock file cabinets, store records in secure areas, log off computers, etc. At Cambridge Memorial Hospital we only provide computer access to agents necessary to perform their job.

*In some cases we are regulated to disclose personal health information without consent.*

 

In a physician’s office, the circle of care would include:

  • the physician
  • the nurse
  • a specialist or other health care provider referred by the physician
    any other health care professional selected by the patient, such as a registered dietitian, pharmacist or physiotherapist


In a hospital, the circle of care would include:

  • the attending physician
  • the health care team (residents, nurses, registered dietitians, technicians, clinical clerks and employees assigned to the patient) who have direct responsibilities of providing care to the individual.


The circle of care does not include:

  • A physician who is not part of the direct or follow-up treatment of an individual;
  • A medical officer of health or a board of health;
  • An evaluator under the Health Care Consent Act, 1996;
  • An assessor under the Substitute Decisions Act, 1992;
  • The Minister, together with the Ministry of Health and Long-Term Care; and
  • Canadian Blood Services

Not without your consent, or unless we are regulated to do so.

An individual who makes decisions on your behalf for treatment, sharing and accessing your Personal Health Information. This person may be your power of attorney, parent, spouse, capable child (at least 16 yrs old) or person that you have chosen to make decisions for you.

The written request for access must include your name, date of birth, mailing address as well as a description of the information you are requesting. The request must be dated, signed by you and witnessed by another person.

The Public Hospitals Act states we must keep your personal health information for a minimum of 10 years after you turn 18 years of age.
 

The Public Hospitals Act also states that we are required to keep your radiology film for a minimum of 5 years after you turn 18 years of age.

Not without your consent, or consent of your substitute decision maker where applicable. In the event of your death, we would still require consent from the highest authority such as the Estate Trustee to provide access to family members.

Consent is required for; Insurance Companies, Lawyers, Police, Researchers, Employers, etc.
 

Cambridge Memorial Hospital will not provide access to your Personal Health Information to any individual or organization outside your health care plan, unless we are regulated to do so.
 

If you are unable to provide consent directly to the hospital, your substitute decision maker such as your power of attorney, parent, spouse, or capable child must sign the consent. The person is bound by law to act on your behalf and to make decisions based on their belief of what you would wish to be done if you were able to decide yourself.

No, access is only provided to staff who have a “need to know” to carry out their duties
 

Healthcare professionals directly involved in your care may access your personal health information
 

Staff members in other areas of the Hospital that are not involved in your healthcare may have access to your Personal Health Information for purposes of managing the health care system. For instance, the finance department has access to information to facilitate payment of your bill
 

Privacy audits are performed to ensure that staff who access your records have a need to know.

CMH provides electronic access to personal health information to Physicians. (Not all physicians have electronic access.)
 

We also share your personal health information to a treating physician upon request e.g. fax your test results, physician reports etc. for provision of care.

Access is determined by the capacity of the individual. If a Health Care Practitioner determines that you do not have capacity, then we would require consent from your custodial parent or legal guardian. If you are considered to be capable, then you may access your Personal Health Information without parental consent.

To obtain records for individuals who are deceased, proof of executorship or legal signing authority must be submitted with the request.