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Medical Records

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:

8 A.M. to 4 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

Checking the Status of Your Request

Doctors' Hospital of Michigan has partnered with MRO to process the release of your medical records. If you are calling to check the status of your request you can contact MRO at 888.252.4146.  If you have received an e-mail, fax or letter from MRO acknowledging your request you can track the progress of the request at www.mrocorp.com and click on "Requestor Login" on the top right corner of the screen. 

 

Records processed by MRO will require pre-payment which can be made via their website by credit card or by mail with a check.

 

All releases performed onsite at DHM will require payment by cash, check or money order.

Fees –

For continuation of care, a “basic packet” of your medical information will be sent to a healthcare provider free of charge. This packet consists of recent discharge or clinic summaries, letters, procedure notes and diagnostic testing results. Patients will be charged $1.10 per page for pages 1-20, $.55 for pages 21-50 and $.23 for pages 51 and up

 

Records requested by a third party for legal, insurance, or other use will be charged an initial fee of $22.08 in addition to the fees above. 

 

Birth Certificates and Death Certificates –

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.

 

 

 
Contact
Doctors Hospital Of Michigan, 461 West Huron, Pontiac, MI 48341


Phone: (248) 857-7200

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