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Patient & Visitor Information
For Our Patients
Release of Patient Information
How do I request a copy of my health record?
To release personal health information, an original consent from the patient or his/her legal representative is required. The consent must be directed to Trillium Health Centre, dated within three months, witnessed by another person and must identify specifically which visit or clinical information is being authorized to be released and to whom the information is being released.
Click here to access our Consent to Disclose, Transmit, Access or Examine Personal Health Information Form.
Do I need parental consent if I am a child?
Parental consent is required if the child is less than 16 years of age and not capable of consenting, otherwise the child can consent to disclosing their information. If there is a conflict between the child and the parent, the capable child's decision prevails with respect to the consent.
How do I request a copy of records for a deceased patient?
To release personal health information of a deceased patient, consent is required from the executor of the estate (with proof, copy of first and last page of Will). If no Will exists, a Certificate of Appointment of Estate Trustee is required.
Is there a fee for requesting personal health information?
There is no fee to release patient information to other health care facilities or physicians for continuity of patient care. For other purposes, an administrative charge may apply based on the current fee schedule (see below). Our Release of Patient Information area will inform you of the cost prior to completing the request.
| Request | Fee | Additional Cost |
|---|---|---|
| Visit History | Free | |
| Letters: birth, attendance, labour & delivery information | $30.00 (first 20 pages) |
$0.25 per page thereafter |
| Patient access/personal use (including oncology patients and hospital staff) | $30.00 (first 20 pages) |
$0.25 per page thereafter |
| Legal | $30.00 (first 20 pages) |
$0.25 per page thereafter |
| Insurance | $160.00 (first 20 pages) |
$0.25 per page thereafter |
| Best Doctors | $30.00 (first 20 pages) |
$0.25 per page thereafter |
| Criminal Injuries | $140.00 | |
| College | $0.25 per page | |
| WSIB | $48.15 | |
| Consent & Capacity Board | Free | |
Additional Fees |
||
| Search and retrieval (includes first 20 pages) | $30.00 | |
| Rush (1-5 business days) | $300.00 plus regualr fees | |
| Patient review | $6.75/15 minutes | |
| CD | $40.00 (includes $30.00 search and retrieval fee) | |
| Microfiche copies | $0.50 per page plus regular fees | |
| Off-site storgage retreival | $25.00 plus regular fees | |
| Fetal monitor strips | $30.00 plus regular fees | |