Frequently Asked Questions Medical Records

Can I view my medical history online?

You can sign up for Henry Ford MyChart which allows you to review your medical history (lab, test results, current immunizations, preventive care and medical/surgical history) on a secure line, free to use and available 24 hours per day.

How do I request a copy my Medical Records?

Print and complete the Patient Information Release Authorization. This form must be signed and dated.

Who may sign the Patient Information Release Authorization?

Only the patient, the patient's legal guardian, the parent of a minor patient or the personal representative of a deceased patient may sign. If the patient is not signing, a copy of the Letters of Authority as Legal Guardian, Medical Power of Attorney, or Personal Representative must accompany the form. The form must be completed in full (with the exception of #5-which is only for ongoing access in treatment settings). Incomplete forms will be returned.

How do I request a copy of my Behavioral Health Records?

You must complete the Disclosure of Psychotherapy Notes as well as the Patient Information Release Authorization.

How do I obtain copies of my records?

Option #1 - Request by mail
Option #2 - Pick up/Walk in (advance notice preferred)
Option #3 - Pick up: by a person other than the patient

How do I complete item #1 on the Authorization form (Name or title of person or organization and address to whom information is to be)?

Disclosed To: If you wish the record to go to yourself - put your name as the person to release the records to. If you wish someone else to be sent (or pick up) the records put their name (and address for those requiring mailing).

Requested From: This portion should be completed by indicating from which Henry Ford Health System facility you are requesting your records to be sent from; i.e., if your records are at Wyandotte - Indicate: "Requested from: Wyandotte Hospital". If requesting records from Henry Ford Hospital or one of the Medical Group Clinics, indicate: "Requested from: Henry Ford Hospital and Health Network".

What identification is required?

Requested by mail: Signature and address will be compared. Copy of drivers' license may be requested.

Pick Up/Walk In: Drivers' license or valid picture ID will be required.