Medical records and Protected Health Information
Christian Health Care Center (CHCC) is committed to securing Protected Health Information (PHI). PHI is information that can identify you, is related to your health, is related to the care you received at CHCC, or payment for care received at CHCC. Release of PHI requires written authorization. If you would like medical records as they relate to a past stay at our facility, Health Information Management (HIM) staff will provide you with the necessary paperwork to authorize the release of your records. We will securely transfer your medical record to you, your doctor, or health insurer as quickly as possible.
Copies of medical records are available for:
- adult patients accessing their own medical records,
- parent or legal guardian accessing for their minor child,
- power of attorney with proof of legal representation, and
- next of kin requesting medical records of a deceased family member, with proof of legal representation.
Receiving your medical records
Please allow 30 days to process requests for medical records.
Search fees (excluding patients) $10
$1 per page – first 100 pages
Each additional page – $.25 per page
Postage – actual cost for mailing
CHCC will release an abstract of a medical record for a flat $15.
Minimize costs and delays
Requests for all medical records, including progress notes, consent forms, registration forms, and more, can delay the request process and become costly. If you are requesting information for continuing patient care or an overview of care received, a request for pertinent records is probably sufficient.
A request for pertinent records includes provider reports, problem list, medications, immunizations and allergy lists, lab, X-ray, and other test results, if any, for the time period specified in the patient’s representative authorization.
To submit a request for medical records:
Authorization of Release of Information Form
Print and complete the release form, and mail or email it to:
Christian Health Care Center
Health Information Management Department
301 Sicomac Ave.
Wyckoff, NJ 07481
Attention: Connie Williams
HIM office hours: 7:30 a.m. to 3:30 p.m. Monday through Friday, except holidays.