Release of Medical Records

Have you received a letter from your doctor notifying you that Shoreline is the Custodian of your medical records? If so, please follow the next steps 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 medical record may be released to the patient only upon written request. Exceptions are as follows: medical record release form
    • 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.
    No other persons will be permitted to sign a record release on behalf of the patient, unless a court order or similar legal directive is presented.
  • Patient's 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 request@shorelinerm.com or by mail.
    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 proper 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 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?

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