Medical Records and Privacy Practices
You can request a copy of your medical records if you are:
- A parent or legal guardian of a patient under the age of 18
- A patient under the age of 18, with legal rights to consent for themselves
- A patient age 18 or older
- A legal guardian of a patient age 18 or older, with written patient consent
- A legal guardian of a patient age 18 or older who doesn’t have the capacity to consent
Form
Request Medical Records
Complete the authorization form to release health information.
Would you like a copy of your medical records, or a copy for your doctor?
Complete and sign the Authorization for Release of Medical Records Form. Fax or mail the form to Westside, and we will typically process your request in seven to 10 business days.
Authorization form
Release of Medical Records (English)
Send this form if you need records for yourself or your doctor.
Formulario en español
Release of Medical Records (Español)
Versión en español del formulario de autorización.
For medical records please send a fax to (302) 322-6201.
Medical Records Contact Information
Privacy
As a part of our effort to provide quality healthcare for the entire family, Westside Family Healthcare is committed to protecting the privacy of our patients, in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Please review Westside Family Healthcare’s Notice of Privacy Practices. This notice is provided to all patients who receive care at Westside Family Healthcare’s offices. It explains how we may use and disclose a patient’s personal health information. The notice also explains a patient’s rights in respect to personal health information, and how a patient can report a suspected privacy protection violation.
If you have any questions about this notice, please contact Lourdes Shea, director of site operations, at (302) 652-2455 ext. 1330.