{"id":51,"date":"2022-01-24T13:32:24","date_gmt":"2022-01-24T13:32:24","guid":{"rendered":"https:\/\/simonmed.wpengine.com\/?page_id=51"},"modified":"2024-04-29T19:05:36","modified_gmt":"2024-04-30T02:05:36","slug":"medical-records-policy","status":"publish","type":"page","link":"https:\/\/www.simonmed.com\/patient-info\/medical-records-policy\/","title":{"rendered":"Access Medical Records"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"51\" class=\"elementor elementor-51\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7e8879af elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"7e8879af\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9f6e420\" data-id=\"9f6e420\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-726223f4 elementor-widget elementor-widget-heading\" data-id=\"726223f4\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.21.0 - 30-04-2024 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h1 class=\"elementor-heading-title elementor-size-default\">Medical Records Policy<\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-92a24de elementor-hidden-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"92a24de\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2e21205\" data-id=\"2e21205\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f961408 elementor-widget elementor-widget-heading\" data-id=\"f961408\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">To protect the privacy of our patients, SimonMed and its affiliates have instituted the following processes when requesting medical records:<\/h5>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-682ac7a elementor-align-center elementor-widget elementor-widget-button\" data-id=\"682ac7a\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/www.simonmed.com\/wp-content\/uploads\/2024\/02\/SM-Release-of-records-2-24-fillable.pdf\" target=\"_blank\" id=\"SimonMed-Release-Of-Information-Form\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download Form Here (English)<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-85be9d3 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"85be9d3\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/www.simonmed.com\/wp-content\/uploads\/2024\/02\/SM-Relase-of-records-spanish-2-24-fillable.pdf\" target=\"_blank\" id=\"SimonMed-Release-Of-Information-Form\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download Form Here (Spanish)<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-66d1bee elementor-widget elementor-widget-heading\" data-id=\"66d1bee\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">To receive your medical record, please complete the following steps in their entirety<\/h5>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bd7d6c4 elementor-widget elementor-widget-text-editor\" data-id=\"bd7d6c4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.21.0 - 30-04-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<ul><li>Fill out each section of the \u201cAuthorization to Release Protected Health Information\u201d form.<\/li><li>You may choose to pick up your medical record by hand carrying the form to any SimonMed Imaging center, or you may submit the form via email or fax and have your medical record sent to you..<ol><li><strong>Email<\/strong>: Please email the completed \u201cAuthorization to Release Protected Health Information\u201d and a photo copy of your valid ID to MedRecReq@SimonMed.com. All requests will be expedited as quickly as possible (no longer than 30 days).<\/li><li><strong>Fax:<\/strong> Please fax the completed \u201cAuthorization to Release Protected Health Information\u201d and a photo copy of your valid ID to fax # <a href=\"tel:6023025958\">(602) 302-5958<\/a>. All requests will be expedited as quickly as possible (no longer than 30 days).<\/li><li><strong>Hand Carry\/Pick up:<\/strong>\u00a0Please take the completed \u201cAuthorization to Release Protected Health Information\u201d form with a valid ID to any SimonMed Imaging center. Please note, wait times may vary for walk-in requests.<\/li><\/ol><\/li><\/ul><p><strong>Please note: A fee of $50.00 per set applies for any film request. As a courtesy to our patients, any request for reports and\/or a CD containing images will be provided at no charge. If the \u201cAuthorization to Release Protected Health Information\u201d form is incomplete, you will be contacted by a Medical Record staff member to request additional information.<\/strong><\/p><ul><li><strong>Direct to Provider.<\/strong> The easiest method is for SimonMed to send your medical records directly to your medical provider please indicate either by fax or email in the \u201cRequesting\u201d section. If the medical provider is capable of receiving medical records electronically, SimonMed reserves the right to send records by secure electronic means. Submit the \u201cAuthorization to Release Protected Health Information\u201d form via fax with a photo copy of your valid identification to fax # <a href=\"tel:6023025958\">(602) 302-5958<\/a> or email to MedRecReq@SimonMed.com.<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7e2e52c mbl-mamography elementor-hidden-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7e2e52c\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-583eff9\" data-id=\"583eff9\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-42e8266e elementor-hidden-desktop elementor-hidden-tablet elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"42e8266e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-435aae40\" data-id=\"435aae40\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c17e738 text-link elementor-widget elementor-widget-button\" data-id=\"c17e738\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/wp-content\/uploads\/2022\/02\/FM.HIM_.001_Authorization_to_Release_PHI_-_English.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">view pdf<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-496dbcd6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"496dbcd6\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-11df16f8\" data-id=\"11df16f8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-68ec4162 elementor-widget elementor-widget-image\" data-id=\"68ec4162\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.21.0 - 30-04-2024 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"100\" height=\"52\" src=\"https:\/\/www.simonmed.com\/wp-content\/uploads\/2022\/01\/icon-why-choose-us.png\" class=\"attachment-large size-large wp-image-443\" alt=\"American College of Radiology\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-61288e5f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"61288e5f\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-248a7442\" data-id=\"248a7442\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-166b3c6 elementor-widget elementor-widget-heading\" data-id=\"166b3c6\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Why Choose Us<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-24af084f elementor-widget elementor-widget-text-editor\" data-id=\"24af084f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>SimonMed Imaging and its affiliates have been serving the community for over 30 years. Our mission is to provide best-in class affordable care through the use of advanced technology. We have patient-focused staff and highly trained medical professionals.<br \/><br \/>SimonMed has over 160 convenient locations across 11 states and provides late night and weekend appointments to accommodate patients.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-36910898 img-choose-wrp elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"36910898\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-3defb853\" data-id=\"3defb853\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5de0dc7c elementor-widget__width-auto elementor-widget elementor-widget-image\" data-id=\"5de0dc7c\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"86\" height=\"80\" src=\"https:\/\/www.simonmed.com\/wp-content\/uploads\/2022\/01\/radsite2.png\" class=\"attachment-medium size-medium wp-image-409\" alt=\"RadSite Logo\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8f65def elementor-widget__width-auto elementor-widget elementor-widget-image\" data-id=\"8f65def\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"88\" height=\"80\" src=\"https:\/\/www.simonmed.com\/wp-content\/uploads\/2022\/01\/icon-top-doctor.png\" class=\"attachment-medium size-medium wp-image-406\" alt=\"Top Doctor Icon\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7098644f elementor-widget__width-auto elementor-widget elementor-widget-image\" data-id=\"7098644f\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"78\" height=\"80\" src=\"https:\/\/www.simonmed.com\/wp-content\/uploads\/2022\/01\/icon-interelated.png\" class=\"attachment-medium size-medium wp-image-407\" alt=\"Intelerad Logo\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a4b3319 elementor-widget__width-auto elementor-widget elementor-widget-image\" data-id=\"a4b3319\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"81\" height=\"80\" src=\"https:\/\/www.simonmed.com\/wp-content\/uploads\/2022\/02\/life_logo.png\" class=\"attachment-medium size-medium wp-image-755\" alt=\"LifeImage\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-941dc1c elementor-widget__width-auto elementor-widget elementor-widget-image\" data-id=\"941dc1c\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"81\" height=\"80\" src=\"https:\/\/www.simonmed.com\/wp-content\/uploads\/2022\/01\/icon-sectra.png\" class=\"attachment-medium size-medium wp-image-408\" alt=\"Sectra Logo\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-17c2a099 elementor-widget__width-auto elementor-widget elementor-widget-image\" data-id=\"17c2a099\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"81\" height=\"80\" src=\"https:\/\/www.simonmed.com\/wp-content\/uploads\/2022\/01\/icon-radsite.png\" class=\"attachment-medium size-medium wp-image-405\" alt=\"RadSite Icon\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Medical Records Policy To protect the privacy of our patients, SimonMed and its affiliates have instituted the following processes when requesting medical records: Download Form Here (English) Download Form Here (Spanish) To receive your medical record, please complete the following steps in their entirety Fill out each section of the \u201cAuthorization to Release Protected Health [&hellip;]<\/p>\n","protected":false},"author":10,"featured_media":0,"parent":46,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Access Medical Records - SimonMed Website<\/title>\n<meta name=\"description\" content=\"Medical Records Policy To protect the privacy of our patients, SimonMed and its affiliates have instituted the following processes when requesting medical records\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.simonmed.com\/patient-info\/medical-records-policy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta 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