Release of Medical Records
Learn how to receive your copy
Have you received a letter from your doctor notifying you that Shoreline is the custodian of your medical records?
If so, please check the information below and we'll gladly help you:
- A patient may request in writing or by email a complete copy of his or her medical record. A patient's medical record may be released to the patient only upon written request. Exceptions are as follows:
- A parent or legal guardian will be required to sign the medical records release form if the patient is a minor.
- A legal guardian, attorney ad litem, or an agent given medical power of attorney must sign if the patient has been judged (by a court or physician) incompetent to manage his or her personal affairs.
- Access to the medical records of a deceased patient is restricted by law to someone who is designated as a legally authorized personal representative of the deceased. Relatives do not always have access to a deceased patient's medical record.
- Patients or authorized parties acting on their behalf may request copies of the patient's medical record by submitting a completed and signed Patient Initiated Release of Medical Information form either in person, by submitting an email request to email@example.com or by mail.
The patient or authorized requestor must submit a picture ID as proof of identity and a completed credit card authorization form.
- Medical records will be made available to the authorized requestor within 72 hours from the date of request. A fee of up to $1.00 per page is required for release either by mail or secure electronic transfer. Payment must be received prior to releasing the records.
- Shoreline Records Management personnel will contact the requestor with the page count and cost of releasing the record. Once payment is processed, the medical record is released either by mailing a physical copy or sending a secure password-protected electronic transfer.
Would you like to get a copy of your medical record?
Fill out this quick form and we'll be in touch shortly.