Physicians' PortalDescription
REVIEWING OR OBTAINING YOUR HEALTH RECORD
Patients are entitled to access their health information. Mental health requests may be subject to approval by the health care provider.
All requests must be made in writing by completing a Consent to Disclose, Transmit, Access or Examine Personal Health Information Form 
and include:
Original Signature of patient or Substitute Decision Maker ( SDM)
Date of authorization - this must be within 90 days of the request.
Witness -the signature of a person verifying that the patient or the SDM did in fact sign the authorization.
Name of recipient - the person or company to whom the information may be disclosed
Purpose of Request – ex. further treatment, legal request, family records
Treatment date – if the exact date is unknown please provide an approximate range
Health Information Management is unable to review or advise upon personal health records. We recommend that health information be reviewed in conjunction with your health care provider, so that interpretation may be provided if necessary.
FEES
There is no fee for information given to health care providers
| Patients | $30 for 1-20 pages of medical information. $0.25/page thereafter Copy of the visit history – no charge. |
| Lawyers and Insurance | Prepayment of $30 for 1-20 pages $0.25/page thereafter |
| Letters | $30 (ex. Confirmation of Attendance, Birth Letters and non-medical birth information i.e. time of birth) |
| Rush (<48 hours) | $300 plus regular fees |
Records are processed according to medical priority sequencing, and will be completed in a timely fashion.
Completed requests can be mailed to:
Credit Valley Hospital
2200 Eglinton Avenue West
Mississauga, ON L5M 2N1
ATTENTION: Health Information Management, Release of Information
Phone: 905-813-4325
Fax: 905-813-4101
Privacy Officer:
Cindy Ferrier-Hastie
905-813-3830
chastie@cvh.on.ca
help us improve this page »