UTHSC
Subject: Disclosure and Release of Medical Records (Maintenance of Medical and Dental
records)
Effective: April 14, 2003, Revised July 10, 2003
Objective:
This policy addresses common situations regarding disclosure of patient information, release of information
and the protection of patient confidentiality. It is not intended to be inclusive of every issue which might
arise. When unusual or questionable situations present, contact the Health Information Management
Department for clarification or consult with the UTHSC legal counsel.
Ownership
Medical Records are the property of UTHSC but subject to professional ethics, federal and state laws the
patient has ownership and control of the information and who may gain access. Unless restricted by other
state or federal law, UTHSC must furnish to a patient or a patient’s authorized representative, without
unreasonable delay, such part or parts of the patient’s medical record requested. UTHSC may require
advance payment of the reasonable costs of copying and mailing medical records.
The medical record contains information acquired in a doctor-patient relationship which is considered to be
a confidential and sometimes privileged communication. UTHSC is responsible for preventing access to
or unauthorized disclosure of a patient’s medical record by unauthorized persons. Release of information
should be carefully screened and disclosed or given out only in response to proper inquiry.
Locations of medical records systems include, but are not limited to, the following practice sites of UTHSC
departments
 College of Dentistry
 HELP Center
 University Health Services
 Family Medicine (Union Ave, St. Francis, Tipton Co. and Jackson) Knoxville?
 University Therapists
 Boling Center for Developmental Disabilities
Removal of Records from UTHSC Premises
Records should not be removed from the various practice sites without the consent of the business or clinic
manager. The availability of the record for treatment and review is compromised when providers remove
records without providing notification. Records found in non-practice sites should be returned to the
appropriate records area upon discovery.
Original medical records should be removed only by court order or subpoena. In such cases, a complete
copy of the record should be made prior to removal. Upon return, the original should be compared to the
copy prior to storage. Any alterations to the original should be noted and brought to the attention of the UT
General Counsel Office.
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Retention of medical and dental records
Medical and dental records shall be kept for a period of ten (10) years or for minors until the age of
majority (18 years) plus one year, whichever is greater. After this time records can be destroyed by
shredding, burning or other approved means. Records should be destroyed in the ordinary course of
business and a log (including the date of destruction, method of destruction and a description of the records
destroyed) of these records should be maintained for future reference.
Patient’s Right To Health Record Information
The Privacy Act of 1974, Tenn. Code Ann. 63-2-101 and the Health Insurance Portability and
Accountability Act of 1996 mandate rights of persons wishing to gain access to individual records.
Medical and dental offices need to follow policy regarding the patient’s request to view or be provided a
copy of his/her record. When a patient asks to view his/her own record, the physician of record should be
notified prior to the patient’s access to the record. Additionally, individuals should never be left unattended
while reviewing medical records.
According to Tenn. Code Ann.63-2-101, “a healthcare provider shall furnish to a patient or a patient’s
authorized representative a complete copy of such patient’s medical records or a summary of the medical
records at the option of the health care provider, without unreasonable delay upon request in writing by the
patient or such representative”.
Confidentiality of Medical Information
Patient information from medical records, dental records, letters, notes and other documents is regarded as
confidential. HIPAA refers to medical information as protected health information or PHI. Information
may not be released to any persons outside of UTHSC without valid patient authorization. Information
may not be released verbally or in writing, to anyone inside of UTHSC unless that person is involved in the
direct care of the patient. Breach of the confidentiality policy will result in disciplinary action and/or
termination. Refer to the UTHSC personnel policy manual section 580 for the University Code of Conduct
and the Compliance Program for further detail.
Only authorized persons in clinics should release medical information. The release of information by other
UTHSC personnel is strictly prohibited.
Release of Information
Private Utilization Review of Patient Records
Certain employers, HMOs, PPOs, insurance companies, alliances and managed care organizations and
private review organizations may conduct utilization review on patient records. {Agreements should be
developed with such reviewers}. PROs may contract with other organizations to conduct reviews on nonMedicare patients. If performing reviews on non-Medicare patients under contract, PRO representatives
must present authorizations as required of other groups reviewing care or patient records.
If medical or dental records are reviewed by these agencies, it will be recorded in the release of information
log. This disclosure will also be included in a patient’s request for an accounting of disclosures.
Release of Information Without Authorization of the Patient
HIPAA and Tennessee state law directs that information be released to authorized persons in cases of
suspected child neglect, abuse, or sexual abuse; adult abuse; and for reporting required cancer data items;
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and knowledge or suspicion of communicable diseases, including HIV status. According to Tenn. Code
Ann. 33-3-206, 207, 208 and 209, psychiatrists and other qualified mental health professionals and their
employees may also warn intended victims of potential harm at their discretion without the patient’s
consent. The non-custodial parent may also receive medical records without consent if there is
documentation of the requestor’s relationship to the child.
This release or disclosure of information will be recorded in the release of information log. This disclosure
will also be included in a patient’s request for an accounting of disclosure.
Purpose of Review
When a party such as an attorney or insurance representative reviews a medical record or patient
information, it is recommended that the person present identification and that the person sign, date, and
state purpose of review on the back of the authorization he presents. This form is retained with the record.
Representatives of health related boards and the public health department reviewing records under T.C.A.
63-1-117 should also follow the procedure of presenting identification and signing a statement with the date
and purpose of the review.
When medical or dental records are reviewed this disclosure of information must be recorded in the release
of information log. This disclosure will also be included in a patient’s request for an accounting of
disclosure.
Charges for Release of Information
Tennessee law mandates reasonable charges for searching for and copying the medical or dental record.
The following charges are allowed: HIPAA may modify this fee structure.
$20.00 for forty pages or less
$00.25 for each page copied after 40 pages
plus the actual cost for postage
Charges for searching for and copying the record for Worker’s Compensation (T.C.A.50-6-204) are as
follows:
$20.00 for 20 pages or less
$00.25 for each page copies after 20 pages
*NOTE: Indigent patients who request medical record copies to support a claim or to appeal a denial may
not be charged for copies, Reasonable proof of indigency and/or a copy of the denial may be required.
FEE SCHEDULE
Fees shall be required for the following types of requests:
 Armed Forces
 Attorneys
 Disability Determination Services
 Human Services (state agencies)
 Insurance Companies
 Internal Revenue Service
 Law Enforcement Officials
 OSHA
 Patients (non-specific requests)
 Social Security Administration
Fees shall not be required for the following types of requests:
 Healthcare Facilities
 Healthcare Providers Caring for the Patient
 Home Health Agencies
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






Hospice Care
Hospitals
Indigent Patients
Medical Examiner
Medicare Intermediaries
Nursing Homes
UTHSC Physicians
Processing Time
The desired turnaround time for processing requests for medical information is seven working days with an
emphasis on completing requests as they are received. Tennessee law mandates a 10-day turnaround time.
Record requests that are needed for continuity of care, e.g., other healthcare providers, take priority over
requests from non-healthcare providers. Requesting parties and patients should be informed of the seven
working day rule and/or any delays in the processing of requests.
Telephone Requests
In emergency situations, related to the well being of the patient, information may be released by telephone.
The full name of the requesting party, the name of the facility, the name of the physician, telephone
number, extension, purpose of the request and identifying information about the patient shall be obtained
by UTHSC personnel. The telephone number and requesting party’s identity shall be verified prior to
verbally releasing any information by telephone. Upon verification of the requesting party’s authority and
identity and upon location of the patient’s medical record, requested information shall be provided.
When records of patients treated by a UTHSC provider are maintained by another facility such as The
Regional Medical Center at Memphis, UT Bowld Hospital or LeBonheur Children’s Medical Center, refer
the caller to the Health Information Services Department at the appropriate facility. See the
Communication with Family, friends and relatives of patients policy for more details
Facsimile
Requests and valid authorizations may be accepted by facsimile; however, records shall not be returned via
facsimile for routine requests. Medical information may be faxed only in emergency situations. Like
telephone requests, the identification of the receiving party should be verified prior to transmission. A
return receipt via facsimile or phone call should be requested.
Walk-In Requests
Patients should be prompted to submit requests in advance of the date needed to allow enough time for
processing. When a patient arrives requesting copies of records on the same day, the authorized UTHSC
representative shall explain the process and inform the patient that copies shall be sent via mail to the
requestor.
Records should not be copied while the patient waits unless they are needed for emergent patient care. The
patient or requestor should be given a reasonable estimate of time in which records shall be processed.
Each clinic retains the right to establish set hours to accept walk-in requests.
Proper authorization and proof of identification (picture ID) is required for all walk-in requests. All
copying fees should be discussed with the requestor while present in the area.
Requests to review records should be scheduled in advance (if at all possible) during normal business hours
and the physician notified. Valid authorization is required to review records. A UTHSC representative
shall supervise all record reviews by patients.
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Release of Information From Records of Patients Who Are HIV Positive
It is the responsibility of the medical record custodian to protect the privacy of the patient with the human
immunodeficiency virus (HIV). However, state reporting requirements must be fulfilled in an effort to
protect third parties from transmission of the HIV.
As a result of T.C.A. 68-10-101, medical information will be reported as required by state law. Additional
information will be released from the records of
patients infected with the HIV virus only with a written authorization including at least the following:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Name of individual or institution that is to release the information
Name of individual or institution that is to receive the information
Patient’s full name, address and date of birth
Purpose or need for information
Extent or nature of information to be released (example: AIDS test results or diagnosis and
and treatment with inclusive dates of treatment)
Specific date, event or condition upon which authorization will expire unless earlier revoked.
Statement that authorization can be revoked but not retroactive to the release of information made in
good faith
Date of consent is signed (date of signature must be later than the date of information to be released)
Signature of patient or legal representative
Information released to authorized individuals/agencies shall be strictly limited to that information required
to fulfill the purpose stated on the authorization. Authorizations specifying “any and all information” or
other such broadly inclusive statements shall not be honored. Release of information that is not essential to
the stated purpose of the request is specifically prohibited.
The release of information from records of AIDS patients or those tested for the HIV virus must be very
carefully handled because information about test results may appear in many sections of the health record.
Following authorized release of patient information, the signed authorization should be retained in the
health record with notation of the specific information released, the date of release and the signature of the
individual who released the information.
In response to a subpoena, records on patients infected with the HIV virus will be released as required by
state/federal law.
Release of Information Log
In clinical areas with a large volume or medical or dental record requests, a log is suggested to track the
turn around time and status of the authorization for medical or dental record release and disclosure. This
log can be an Excel spreadsheet, an Access database or an alphabetical log book.
Date of
request
Date request
filled
Name of
patient
Name of
requestor
Reason for
request
What was
disclosed
Comments
Authorizations
See the Authorization for access, disclosure and release of protected health information policy
Who can consent to Health Care Services
Any person who is eighteen (18) years or older or a married or previously married (emancipated) minor or
the parent of a child may consent to medical care for himself or herself. A minor who is the parent of a
child may consent to health care services for themselves or their child {TENN. CODE ANN. 63-6-229}.
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The general rule in Tennessee is that parental consent is required for minors unless the parent is unavailable
and the emergency exception applies. When the parent is not available, consent should be sought from (in
order of preference) an adult sibling or grandparent. The health care facility or provider, which accepts in
good faith that the patient is capable of consent, would be relieved of responsibility. However, the health
care facility or provider should be cautious in making the determination, as there are emancipated minors
(those under eighteen (18), self-supporting, with parents who have surrendered their rights of custody, care,
and support) and mature minors (minors over 14 who are not emancipated, but with a high level of maturity
and with capability of understanding the treatment involved). The mature minor exception should be relied
upon only when parents are not available and an emergency exists.
Minors may be supplied with contraceptives and have prenatal care without parental consent. A minor may
be treated for venereal disease, pregnancy, drug or alcohol dependency without parental consent. A minor,
in the absence or unavailability of a spouse, is authorized to consent for such minor’s child, either orally or
otherwise to surgical or medical treatment of procedures not prohibited by law which may be suggested,
recommended, prescribed or directed by a duly licensed physician according to T.C.A. 63-6-229.
In the event of an illegitimate child, only the mother may consent. In the case of divorced or separated
parents, either parent may give consent. If a child is away at school or camp, etc., the parents may delegate
in writing temporary custody to the responsible person or agency, who may in turn consent for care. Proof
of such temporary custody must be available and become part of the consent. If a child is under foster care,
the Department of Human Services or their designated representative, (e.g. foster parents) may consent.
A consent by the husband or wife of a married patient is not necessary; however, it is advisable to obtain a
consent under certain circumstances. Doing so may alleviate any potential claim at a later date. The
situations to be considered are when more than the usual risk of life is involved, or when the patient’s
reproductive capacity is involved or when the patient’s competency is questionable.
A patient may have executed an advance directive or a living will and proper documentation of these must
be included in the record. In the case of the guardianship or person acting as attorney-in-fact, the health
care facility or provider must require legal documentation such as a court order or letter of
guardianship/conservatorship to determine specific rights regarding consent.
The law assumes that a patient is competent in the absence of evidence to the contrary. If there is a
question as to the patient’s understanding what he is consenting to or he is not able to make a rational
decision, consent should be rendered by his court appointed guardian.
Retention of Authorization Forms
Following authorized release of patient information, the signed authorization must be retained with the
medical or dental record with notation of the specific information released, the date of release and the
signature of the individual who released the information. These forms do not become part of the record and
should not be released when the record or information is released. The Federal Privacy Act requires that a
record of disclosures of information be maintained. This applies only to federal facilities but many other
health care organizations have adopted this practice.
Subpoenas, Depositions, Court Orders
Subpoenas. If there are any questions in your department about who the custodian
of records is, or that person is unavailable, contact the UTHSC General Counsel
Office, the Health Information Management Department or your clinic manager for
direction.
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Subpoena for Individually Identifiable Information on patients
As directed by 45 CFR § 164.512 (e), a subpoena is not sufficient authority to
disclose individually identifiable information including health information unless
the subpoena is signed by the judge of a court or accompanied by the written
authorization of the individual whose records are the subject of the subpoena.
This applies to federal, state, municipal and administrative agency subpoenas.
PROCEDURE for SUBPOENA REQUESTS (The process server gave you a subpoena.)
(1)
Verify that you have received a "subpoena" and not a "court order". If you are
unsure about whether the document is a subpoena or a court order, contact
HIM or the Office of General Counsel.
If it is a subpoena duces tecum, inform the requester that as an alternative, he must obtain
a valid court order or a written authorization to disclose the records being sought.
(2)
Check the subpoena to see what is being requested and verify whether there are
patient medical records. If it is a subpoena for a physician to provide a deposition, the
subpoena should be served on the individual.
(3)
If there are no medical records call the number on the subpoena (if there is one)
and notify the requester that there are no records. They may require a Certificate of No
Records. A sample is attached to this policy.
Questions regarding the legal restrictions on disclosure pursuant to a subpoena should be
referred to the HIM or the Office of General Counsel.
Terminology
Subpoena- Written order commanding a person to appear and provide testimony at a trial or other
investigative proceeding.
Subpoena duces tecum- Written order commanding a person to appear and provide testimony and bring
with him the items specified on the subpoena. This is usually the type of subpoena received by the
custodian of records.
Contents of the Subpoena and Subpoena Duces Tecum
1. Name of court or location where proceeding will be held
2. Names of plaintiff and defendant
3. Docket number of the case (This is important to verify that the subpoena represents
an actual case)
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4
4.
5.
6.
7.
Date, time and place of appearance
Specific documents or items requested (if a subpoena duces tecum is received)
Name and telephone number of the attorney responsible for issuance of the subpoena
The stamp of the court and the signature of the clerk or commissioner
Healthcare facility or to which the subpoena is directed
Considerations Upon Receiving a Subpoena
The Health Insurance Portability and Accountability Act of 1996 requires reasonable assurances that the
patient has made a good faith attempt to provide written notice to the patient and given the patient an
opportunity to object. Verify that UTHSC has a patient by the name designated in the subpoena. If not, the
attorney responsible for the subpoena must be contacted and asked for additional information about the
patient. If the patient has records at another facility supported by UTHSC, inform the attorney to contact
that facility.
Subpoenaed records must be reviewed and all correspondence, release of information authorizations, other
subpoenas, etc., which is not part of the record must be removed. The subpoena should be filed with the
medical record. It is unlawful to allow any physician or provider involved in the case to make additions
and/or corrections in the record after the subpoena has been received
UTHSC, as custodian of the information contained in the medical record, has a duty to preserve the
integrity of the documents as legal evidence. Any indication that the records have been altered, tampered
with or partially destroyed reduces their importance as evidence. Even if UTHSC is not involved, UTHSC
may be held liable if records cannot be produced and the plaintiff is unable to pursue a case without the
evidence in the record. Any omission or alteration of the record may undermine confidence in the entire
record. Removal of pages from a paper record can also create the suspicion that the record has been
changed in an attempt to suppress information.
Upon receipt of a subpoena, it should be determined whether or not the case is a potential malpractice suit
against the University or a physician, nurse, dentist, physical therapist, dental hygienist or other provider.
If there is reason to suspect such circumstances exist, the general counsel’s office and appropriate
department business manager should be notified.
Procedure For Mailing Copies of Medical Records
Under certain circumstances, when a patient’s record has been subpoenaed to court or to a deposition,
UTHSC may, in lieu of personally appearing in court with the records, mail the copy of the record to the
Clerk of the Court or to the person before whom the deposition is taken or to the attorney who issued the
subpoena if it
is stated clearly on the subpoena that the records are required for an action or proceeding where the plaintiff
has raised the issue of his physical or emotional condition. This does not apply to Federal Court cases.
Conditions Which Do Not Authorize the Use of Mail-In Procedure
Conditions for which the mailing procedure is not authorized and personal attendance is required are:
1. UTHSC is a party to the action.
2. UTHSC is the place where any cause of action is alleged to have arisen
3. Personal appearance is required.
Procedure Guidelines
Upon receipt of a subpoena, the designated custodian of the medical records may deliver by mail, or
otherwise, a true and correct copy (which may be a photo copy) of all records described in such subpoena
to the Clerk of the Court, or to such person as described in the subpoena . If the mailing privilege is to be
used, the attorney who has requested the subpoena should be notified of the copying costs.
These steps should be followed:
1.
Complete an “Affidavit of Custodian of Medical Records” form and include it with the
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copy of the medical records.
2.
Put the copy of the medical record(s) and affidavit in an envelope, seal it, and write the title
and number of the action, name of witness and date of subpoena on the outside of this envelope.
Example:
Action No:
Witness:
John Smith vs. John Doe
C-1879
Clinic manager’s name
Title
Name of Facility:
Date of Subpoena: 8-05-2002
3.
Enclose the sealed envelope or wrapper containing the records and affidavit in an outer envelope and
address it to the Clerk of the Court, or if for a deposition, to the person before whom the deposition
is to be taken or to the attorney issuing the subpoena.
4.
Deliver the medical records and affidavit in the envelopes personally or send them by certified or
Registered mail or delivery service within five (5) day after the subpoena is received. If the records
or copies of the record are delivered in person, it would be advisable to get a receipt for them.
5.
If there are no records for the patient named in the subpoena, notify the attorney and send a
completed “Certificate of No Records” form to the Clerk of the Court.
Personal Appearance Required
If a personal appearance with the original record is required, the subpoena must contain the following
wording according to T.C.A. 68-11-407: “The procedure authorized pursuant to T.C.A. 68-11-402 will not
be deemed sufficient compliance with this subpoena” or “Original records are required and the procedure
authorized pursuant to T.C.A. 68-11-402 will not be deemed sufficient compliance with this subpoena.”
Contact the attorney who issued the subpoena and ask to be placed ON CALL and notify the attorney of the
costs involved unless the subpoena is for Federal Court in which case a witness fee will be received. It is
good to check with the attorney to see what portion of the record(s) will be examined.
Original Records/Charges For Copies
T.C.A. 68-11-408 states, “In view of the property right of the facility or community mental health center in
its records, original records may be withdrawn after introduction into evidence and copies substituted,
unless otherwise directed for good cause by the court, judge, officer, body or tribunal conducting the
hearing”. The custodian may prepare copies of original records in advance of testifying for the purpose of
making substitution of the original records and the reasonable charges for making such copies shall be
taxed as costs of court. If copies are not prepared in advance, they can be made and substituted at any time
after introduction of the original record and the reasonable charges for making such copies shall be taxed as
costs of court. If it is necessary to leave an original record at court, the attorney who subpoenaed the record
must give a receipt and must be responsible for its prompt return to the facility.
The Medical Record Custodian’s Conduct As a Witness
When the custodian of the medical records is called to the witness stand, sworn in and asked to identify
himself/herself, the following questions are usually asked by the attorney in the introduction of the medical
record as evidence:
1.
2.
3.
Position Title
Length of employment as custodian of the records
Whether one has possession of the records in question at the present time
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4.
Confirmation of how and when the record was prepared (This is usually stated as “in the regular
course of business.”)
The custodian of the records may also be asked to read portions of the record. The following are helpful
suggestions for conduct at court:
1.
2.
Read the medical record before taking it to court.
Comply with any instructions given by the court (the judge) as to retaining possession of the record
and dismissal from the courtroom.
3. Remember that the custodian of the record is not qualified to interpret or render any type of personal
opinion, but is only qualified to read from the record. If one is asked to translate an abbreviation,
one should add a qualifying statement.
4. If asked a question and one is not certain of the answer, one should not hesitate to say “I do not
know.”
5. Do not leave the record in the courtroom unless it is in the possession of the judge or jury and a
receipt is obtained. Try to have the court accept a photocopy of the record to substitute for the
original.
6. Do not answer until the judge has ruled whether or not the question is to be answered, if the
opposing attorney has objected.
7. Remain calm and give clear, concise responses to the questions asked by the examiner and
cross-examiner.
8. The judge will excuse the witness.
Jurisdiction
Subpoenas may be issued to compel the attendance of witnesses to a court hearing or trial, depositions or
various administrative proceedings. Subpoenas issued in connection with lawsuits are generally issued by
or under the authority of the court in which the lawsuit is pending. These subpoenas will generally be
issued by the clerk of the court.
Tennessee Rules provide that a subpoena may be issued by the clerk of the court or ”…other authorized
officer…”. The phrase “…other authorized officer…” although not otherwise elaborated on would clearly
include others (attorneys in the case) who have been granted the authority to issue subpoenas by statute or
by the order of the court (eg., a fire marshall or notary public may issue subpoenas for certain purposes,
T.C.A. 68-102-128.) If there is any question as to the authenticity of the person issuing the subpoena,
immediate steps should be taken by the person subpoenaed to resolve this question.
Federal courts in Tennessee may issue subpoenas within its district or anywhere outside of its district but
within 100 miles of the place of the hearing or trial. Hence, a federal court outside of Tennessee may issue
a subpoena to a person in Tennessee if the hearing is to be held within 100 miles of the place of service.
The same is true of a federal court in Tennessee which issues a subpoena for service outside of its district
and the geographic boundaries of Tennessee. The federal court subpoena must be accompanied by a check
to cover the witness’s transportation costs, etc.
Tennessee courts are generally limited to issuing subpoenas for service within the geographic boundaries of
the state. When the facility is out of the jurisdiction of the court issuing the subpoenas, the facility should
not honor the subpoena without obtaining the patient’s authorization to do so. If the patient authorizes the
release of records, then the facility may choose to honor the subpoena as a courtesy to the court. It is
recommended that the attorney requesting the record be contacted to determine if one of the following
alternative procedures might suffice rather than have the custodian of records appear personally:
1.
2.
A deposition be taken at a place and time convenient to the custodian of the records, or
A certified copy of the medical record be sent to the court or the attorney at the attorney’s expense.
Failure to Comply With A Subpoena
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Failure to respond to a valid subpoena may result in charges of contempt of court.
Depositions
A deposition is defined as testimony taken down in writing from a witness under oath. The testimony may
be taken under oath in a setting other than the courtroom to be used as evidence. The attendance of these
witnesses for deposition may be requested through subpoena. If a subpoena duces tecum is served upon a
person to give a deposition, the materials requested to be produced will be included in the description on
this document. Consent for deposition may also be granted by obtaining the patient’s authorization.
Reasonable notice in writing to all parties involved in the deposition by the party desiring to take a
deposition shall be given. Examination and cross-examination of the witness is conducted as would be
permitted at an actual trial. During the taking of the deposition, the witness should follow the same
guidelines that would be used during an actual trial proceeding before a court.
The witness should always take time to answer the questions asked and be certain that questions asked are
understood. Questions should be answered with as few words as possible. Do not allow the attorney to
prompt you into further explanations by volunteering more information than is required.
The witness should answer clearly and audibly so that the court reporter can understand the answers. The
attorney has the right to ask questions, some of which may not be pleasant. The witness should not argue
or lose his/her temper.
Court Orders
Often Federal or State courts order a facility to release a patient record or other patient information that is
considered confidential. When this occurs, a written order is issued by the court and signed by a judge
instructing the facility to produce the requested information. Court orders are served in a similar fashion to
that of subpoenas and should be processed in the same way. Court orders are valid as long as the case in
question is in litigation. It is recommended that if a court order is presented with a date older than one year
the respective clerk’s office be contacted to verify that the case is in litigation.
Appendix
A
B
C
D
E
Authorization Form
Affidavit of record custodian
Certification of No Records
Combination affidavit and Certification of No Records
Release of Information Tracking Log
Also reference UTHSC policy on Authorization for access, disclosure and release of
protected health information
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