St. Mary's Health Information Management Department is committed to maintaining complete and accurate patient data and making it available in a timely fashion.

By law, patients have the right to inspect their medical records, to receive copies of their medical records or to obtain a summary of their records. Original medical records are the property of the hospital. Our staff is available to assist you with requests for medical records.

Accessing Your Medical Records
To receive access to your medical records, or to have them released to others, please complete one of the following forms:

• To access your medical records -- Patient Request for Access to Protected Health Information
• To release your medical records to others -- Authorization for Use and/or Disclosure of Protected Health Information

Please send your request to:
St. Mary's Health Information Management Department
450 Stanyan Street
San Francisco, CA  94117
(415) 750-5842

Fax your request to:
(415) 750-8121

To review your medical records
You can review your medical records within five working days after we receive your written request. Our staff will notify you when your records are ready for inspection, and set up an appointment. You can review your records in the Health Information Management Department under visual supervision. Appropriate photo I.D. is required to maintain patient privacy. There is no cost to inspect your records.

Hours
Monday through Friday (except holidays)
9:00 a.m. to 4:00 p.m.

To receive copies of your medical records
Copies of medical records will be available within 15 days after St. Mary's receives your request and payment of fees. Exceptions to this time allowance may occur if the patient was recently discharged or if the record is incomplete or unusually large.

If the cost to copy your medical records exceeds $20.00, we will notify you for fee approval. Appropriate photo I.D. is required to pick up copies of medical records. If a physician's approval is required prior to release of medical records, additional time may be necessary.

There is a processing fee to make copies of medical records. This fee must be paid in full before St. Mary's can fulfill your request.

Copies of Medical Records -- $.25 per page plus tax and 5% shipping and handling when applicable

No charge if records are sent to health professionals

When another physician or hospital requests your medical records to continue your medical care, there is no charge. If your insurance company, school, employer or other third party needs information about your medical history, it is more cost effective to have them request it directly. They can be more precise about what information they need. To authorize these third parties to view your medical records, you must complete the Authorization For Use and/or Disclosure of Protected Health Information Form.

• Psychiatric records: The hospital may deny a medical records request if the physician/provider believes there may be significant adverse consequences of disclosure. If this occurs, the patient may name a licensed physician, psychological or social worker to inspect or receive copies.
• Parent or Guardian: The hospital may deny access to a parent or guardian when disclosure may have a detrimental effect on the treatment relationship with the minor.
• Alcohol/drug abuse records: Federal regulations place some additional limitations on access to these records. These limitations are the same as those referenced in "psychiatric records."