Health Information Management
360 Broadway
PO Box 403
Bangor ME 04402-0403
FREQUENTLY ASKED QUESTIONS - Related to Requests for Medical Records
Q: How do I request a copy of my medical records (including hospital or physician office
practice medical records and x-ray films)?
A: You may request a copy of your medical records by completing a “Written Authorization to
Release Copies of Healthcare Information” form and submitting it to the Health Information
Management Department (Medical Records Department). If you are submitting your request in
person in the Health Information Department, you may do so from 8:00 a.m. to 4:30 p.m.
Q: When will I receive a copy of the medical records?
A: Although legally we have up to 30 days to process requests for medical records, we make
every effort to respond to your requests within a much shorter turnaround time. Please make
sure you have provided your telephone number and required date if needed for a specific
appointment.
Q: May I obtain a copy of medical records other than my own?
A: Generally you may not; however, there are some exceptions.
 Patient has completed the authorization form to release the medical records to you on
their behalf.
 If you are the patient’s legal guardian. Please provide proof of legal guardianship.
(Example—Court document)
 If you have been appointed by the patient as their legal representative. Please provide
a copy of the legal document. (Example—Medical POA)
 If the patient is a minor (under 18) and you are the parent or legal guardian.
 If patient is deceased and you are patient’s representative or Executor of patient’s
estate. Please provide a copy of the legal document.
Q: How will I obtain copies of my medical records related to services by my
physician/provider at his/her office?
A: If your physician/provider is part of the St. Joseph Healthcare system, you will be able to
request your medical records by contacting or visiting the Release of Information Coordinator
who is located in the Health Information Management Department (“Medical Records”) of the
hospital or by calling 907-3341.
Q: How much information do you send for each request?
A: We limit the information sent to the minimum necessary for the purposes stated in your
request. You may specify on the request form that specific information not be disclosed.
Q: Who is authorized to sign for release of my health information?
A: The following people are authorized to sign for release of your health information:
 The patient (not the spouse)
 Power of Attorney if the patient is unable to sign (Legal document must be provided)
 Parent (if the patient is under 18)(Certain exceptions apply)
 Legal guardian (Proof of guardianship document must be provided).
 Representatives of the estate for deceased patients (Copy of legal document must be
provided, i.e. executor of estate or court appointed representative documents)
Q: If I find incorrect information in my records, how do I request an amendment?
A: Please contact the Release of Information Coordinator in the Health Information
Management Department (Medical Records Department). An amendment request form will be
provided to you.
Q: Is there a charge for copies of my medical records?
A: There is NO charge if your medical records are required for continuity of medical treatment.
Q: Where do I pick up my medical records?
A: Copies of medical records for both the hospital and physician practices may be picked up in
the Health Information Department located on the 4th Floor of the hospital.
Q: Who do I contact if I have questions?
A: If you have any questions, please contact the appropriate Release of Information Coordinator
within the Health Information Management Department.
 If you are requesting hospital related medical records, please contact Shannon
Wallace at 907-3648 or Amanda Herald at 907-3208.
 If you are requesting medical records from St. Joseph Healthcare physician office
practices, please contact Marjorie McCann at 907-3341 or Tina Farias at 907-3209.

List of Physician Office Practices:
o St. Joseph Internal Medicine
o St. Joseph Family Medicine – Evergreen Woods
o St. Joseph Family Medicine – Brewer
o St. Joseph Family Medicine – Broadway
o St. Joseph Family Medicine – Hampden
o St. Joseph Family Medicine – Jackson Lab
o St. Joseph Cardiology
o St. Joseph Endocrinology
o St. Joseph Gastroenterology
o St. Joseph General Surgery
o St. Joseph Orthopedics
o St. Joseph Respiratory Care
o St. Joseph Rheumatology
o St. Joseph Neurology (closed but records still available)
o St. Joseph Pain Management (closed but records still available)