Obtaining Copies of Your Medical Records
Medical records can be released to the patient or anyone that the patient authorizes by completing the medical records authorization. It may take 7-10 business days to process your request. There may be a fee charged for your medical records.
Medical Records Online Request
To request your medical record electronically you must have your valid e-mail address, cell phone and driver’s license or government issued photo i.d. available to verify your identity.
Print a Medical Records Authorization Form
Please send the completed and signed medical records authorization to the Henry Ford Health Information Department:
Email: [email protected]
Fax: (313) 916-3917
Mail: Henry Ford Health Information Department
1414 E Maple Road
Troy, MI 48083
The medical records authorization MUST contain the following information, or the request will be returned:
- Patient's full name, date of birth, address, phone number (include any previous names)
- To whom the information is to be sent (name and address)
- Specific information being requested (e.g., location of treatment, provider name, type of report/information and dates of service, etc.)
- Signature of the patient or the patient's legal representative. Authorizations signed by a representative must contain a copy of the guardianship papers or power of attorney
- Date of the signature
Birth and Death Certificates
To obtain a copy of a birth or death certificate contact the county clerk’s office in the county the birth or death occurred or from the Michigan Department of Health and Human Services.
MI Department of Health and Human Services Contact Information: