(415) 353-6310
The Health Information Management Department (formerly called Medical Records) at Saint Francis Memorial Hospital maintains complete and accurate patient data. To release your records, please complete one of the following forms:
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Form 8700-889 (AUTHORIZATION FOR USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION) is used when the patient want the records to go to anyone other than themselves.
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Form 8700-101 (PATIENT’S REQUEST FOR ACCESS TO PROTECTED HEALTH INFORMATION) is used when the patient wants a copy of their records for themselves.
Please send your request to:
Saint Francis Memorial Hospital
Health Information Management Department
900 Hyde Street
San Francisco, CA 94109
Or you can fax your request to: (415) 353-6316
How Long Does it Take?
Within five working days after we receive your written request, you can review your medical records. 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. Records can be viewed by making at appointment.
To receive copies of your medical records:
Copies of medical records will be available within 15 days after your request and payment of fees are received. Exceptions to this time allowance may occur if the patient was recently discharged or if the record is incomplete or unusually large. 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.
Copying Charges:
There is a 25 (twenty-five) cents charge per page to make copies of medical records.
