Your Medical Record
The results of all diagnostic studies and medical treatment you have received while you are hospitalized or treated as an outpatient are documented in a medical record. In addition, the medical record will contain physician reports and observations by nurses and other members of your health care team. This information is combined to make up your medical record at Doctors’ Hospital of Michigan (DHM).
Obtaining Copies of Your Medical Records –
Release of Information (ROI)
Hours of Operation:
7 A.M. to 3 P.M.
Monday – Friday
Closed Weekends and Holidays
If you would like to get copies of your Medical Records, please print off the "AUTHORIZATION TO RELEASE PATIENT INFORMATION" form here.
To be used when the patient (or designated individual) is requesting their DHM health information to be SENT to someone outside the institution.
Records can be released to anyone that the patient authorizes (in writing). A valid authorization MUST contain the following information or the request will be returned:
- Patient's full name and date of birth (list any other names the patient may have had
- Specific information being requested (e.g., type of report/information and dates of service, etc.)
- Purpose for which the information may be disclosed
- To whom the information is to be sent (name and address)
- Specify authorization’s expiration date if desired
- The patient's signature or a patient's legal representative’s signature. Authorizations signed by a representative must contain a copy of the guardianship papers or power of attorney
- Date of the signature.
Requests for medical records may be mailed or faxed to:
Release of Information
461 W. Huron St
Pontiac, MI 48341
Phone – 248.857.7266
Fax - 248.857.6894
NOTE: DHM does not provide copies of birth or death certificates. For information about how to obtain a copy of a these certificates, please call the Oakland County Clerks Office of Vital Records at 248.858.0581.