Medical Records

How do I obtain my medical record? How much does it cost to get my records? Who has access to my records without my consent? What is considered Super Confidential information? Is there any time when I may not get my record? How long does Naples Day Surgery retain my record? As a minor, is there anyway that I can get my record? How do I obtain the record of someone that is deceased? What information should I request?

How do I obtain my medical record?

Your medical record belongs to Naples Day Surgery. The information within the record however, belongs to you— the patient. You may obtain your record (or in the case of a minor, the parent or legal guardian), by completing a Release of Information Consent. Obtain this form by calling the Medical Records Department, 239-552-4524. The form may be sent to you by mail or fax but the documents cannot be faxed. Once your consent is received, a copy of your record will be sent by certified mail or you may pick it up at the facility where the procedure was done. When picking it up, you will be asked to provide a picture ID before the documents are released.

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How much does it cost to get my records?

The cost is a flat rate of $15.00.

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Who has access to my records without my consent?

Your physician that performed your surgery or procedure has access to your medical record. Your insurance company, Medicare and/or Medicaid would also have access if they are involved with the payment of your bill. A subpoena of your medical record could be ordered by the court. Your record would be available to medical providers involved with your ongoing care related to your surgery. Your record might also be used for research purposes but your name would not be disclosed. Anyone else requesting your record would only be able to obtain access with your written consent.

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What is considered Super Confidential information?

Super confidential information includes documents that disclose:

  1. Substance abuse including alcohol,
  2. Mental/emotional history,
  3. Sexually transmitted disease,
  4. HIV/AIDS

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Is there any time when I may not get my record?

Access to your medical record may be withheld from you if your physician believes that the information in the record might be harmful to your well-being and safety.

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How long does Naples Day Surgery retain my record?

Your record is kept for 10 years before it is destroyed. In the case of a minor, the record is kept for two years after his or her eighteenth birthday.

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As a minor, is there anyway that I can get my record?

If you are a minor and are married or emancipated by the court, you would have rights to obtain your medical record.

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How do I obtain the record of someone that is deceased?

You may obtain the medical record of a deceased individual if you produce an order showing that you are the Executor of the Estate or have a copy of a notarized Death Certificate.

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What information should I request?

Request the following information:

  1. History/physical
  2. Pre-operative laboratory work
  3. Report of operation
  4. Implant information
  5. Post-operative laboratory work
  6. Pathology report
  7. Anesthesia record

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