To request records, you will need to complete the following documentation:
- Medical Records Request
- Authorization to Release Health Information:
Drug & Alcohol Program
All other programs
For our clients:
- To request your treatment records, you must complete the Medical Records Request webform or come to the office to complete a paper Medical Records Request.
- Records must be picked up by the person receiving services, from the location services were provided. In order for our staff to turn over records, individuals must show a valid photo ID and sign a receipt that records were received..
- To authorize us to forward a copy of your medical record directly to a physician or other entity, you must complete a HIPAA compliant authorization form. You can download our form online and submit a copy with your signature to firstname.lastname@example.org, or you can sign a paper copy at our office. You can also submit a similar release form supplied by your healthcare provider. Medical records will not be released without a written authorization.
To other requestors (such as attorneys, human service organizations, and government agencies):
- You must submit a letter requesting medical records and should not use the Medical Records Request form to request records.
- We require a signed HIPAA compliant authorization form to release any records. You can download our form online or you can submit a similar release form supplied by your organization.
- Letters & signed authorizations can be emailed directly to email@example.com
The Wedge Recovery Centers are committed to protecting your privacy. Our staff members treat your medical information in compliance with federal and state requirements. For continued patient care directly to a physician’s office or healthcare facility or in the event of an emergency, The Wedge will also request written authorization by the patient or responsible physician. The Wedge will not release any medical information to you or your designated representative without your written authorization (except as required or permitted by law).
Please note that in compliance with Pennsylvania law (49 Pa. Code § 16.95(e) ), facilities are required to keep medical records for the period of 7 years. And please allow up to 30 calendar days to receive copies of your medical records after we receive your written request. Also please note we do not mail/email any medical records, nor can we confirm identity over the phone.
If you have any questions regarding requests for copies of medical records, please contact the Medical Records department at firstname.lastname@example.org