Release of Protected Health Information
Ask our expert about how to obtain your medical records
Q: How can I get copies of my medical records from the hospital?
A: Before you can obtain your medical records, you must fill out a “Consent for Release of Protected Health Information” form. To obtain a copy of the form, you can:
- Click here for a form in English.
- Click here for a form in Spanish.
- Call the health information management (medical records) department at 610-402-8240.
- Pick up a copy in person at Lehigh Valley Hospital-Cedar Crest or Lehigh Valley Hospital-Muhlenberg. (Ask for specific directions at the information desk.)
The consent form must be filled out in its entirety, signed and dated by the patient, the patient’s guardian, or the person authorized to consent on behalf of the patient.
Q: Who is authorized to sign for the release of protected health information?
A: People authorized to receive medical records include:
- Patient
People authorized to consent when a patient is incompetent include:
• Legal guardian (court-appointed guardian or parent of a minor child)
• Health care agent (person designated in a health care power of attorney to make health care decisions for the patient)
• Health care representative (person designated by the patient to make health care decisions for him or her in writing or by notifying his or her attending physician)
If an incompetent patient does not have a legal guardian, health care agent or health care representative, the following persons in the following order of categories of relationship, who are reasonably available, may act as such:
• Current spouse, unless an action for divorce is pending, and the adult children of the patient who are not children of the spouse
• Other adult children
• A parent
• Adult brother or sister
• Adult grandchild
• An adult with knowledge of the patient’s preferences, values and beliefs - Parent (if the patient is under the age of 18)
Exception: A minor age 14-17 receiving psychiatric, alcohol or drug treatment services must consent to release his or her records - Emancipated minor – any person who is 18 years of age or older, or has graduated from high school, or has married, or has been pregnant, may give effective consent to medical, dental and health services for himself or herself and the consent of no other person shall be necessary. In addition, a court can legally declare a minor to be emancipated after a formal hearing and subsequent Order of Court.
- Any minor who has been married or has borne a child may give effective consent to medical, dental and health services for his or her child.
- Representative of the estate for deceased patients (executor, surviving spouse or surviving adult child if there is no spouse). A copy of estate documents must be provided.
Q: Where do I send a completed “Consent for Release of Protected Health Information” form?
A: You may mail or fax it to:
Hospital (Inpatient and Outpatient Visits) Records
Lehigh Valley Health Network
Attn.: Release of Information
Cedar Crest and I-78
Box 689
Allentown, Pa. 18105-1556
Fax: 610-402-5823
LVPG Physician Office Records and Satellite Locations
Mail or fax the completed form to the physician office or satellite location where you received care.
- Click here for a list of LVPG physician practice locations.
- Click here for a list of satellite locations.
Home Care and Hospice Records
2166 12th Street
Allentown, Pa. 18103
Fax: 610-969-0454
Q: How can I get my medical records from my family physician’s office?
A: You must contact your family physician directly. Specific guidelines vary from office to office.
Q: Is there a cost to obtain a personal copy of my medical records?
A: Yes. Fees are regulated by the Commonwealth of Pennsylvania. For information, click here.
Q: What is the procedure if I need Lehigh Valley Health Network records sent to another physician’s office or hospital?
A: You must submit a written authorization form/letter including the name, address and/or fax number of the requesting physician or hospital. There is no charge for this service.
Please note that radiology images (X-rays), telemetry tapes or photos are not sent as part of your medical record. You must contact the office that provided the service to receive a copy of the documentation. If you received a radiology test at Lehigh Valley Health Network and need to forward a copy of radiology images to another doctor or hospital, call 610-402-CARE and ask for the office where the images where initially taken.
Q: How soon can I expect the release of my medical records?
A: The typical turnaround time is 7-10 days from the time the request is made. Record requests are processed through the mail.
Q: Am I able to view my record?
A: Yes. To view your records your must schedule an appointment with the health information management office by calling 484-884-3826. There is no charge to view your records.
Q: Can you provide my medical information over the phone or by fax?
A: We are not able to confirm identity over the telephone. Because we must protect patient confidentiality, we do not supply information over the phone. It is also important to note that representatives from health information management do not provide direct patient care and cannot explain test results.
If immediate patient care is needed, we can fax records to a physician's office or health care facility. It is not necessary for the patient to be in the office when the fax is received – only that an appointment is scheduled for some time that day or the following day. If that is not the case, copies of medical records will be mailed or held for pickup. Whenever possible, please request records far enough in advance so they can be mailed.
Q: How can I get a copy of my birth certificate?
A: Copies are only issued by the Pennsylvania Department of Health, Division of Vital Records. For more information, click here
Q: How does the Health Insurance Portability and Accountability Act (HIPAA) restrict access to my health information?
This act was passed by Congress in 1996 to assure that the privacy of your personal health information is protected, while allowing the flow of information needed for your care. It permits the sharing of your information among physicians, hospitals, laboratories and other medical facilities involved in your treatment. With your consent, your personal medical information may also be sent to your insurance company, worker’s compensation agencies, legal offices and several other entities. You may also give your consent for someone responsible for your care, like a spouse, to have access to your health information. At Lehigh Valley Health Network, we are committed to efficiently transferring information needed for your medical care, while also ensuring your privacy and complying with all HIPAA regulations.
This page last updated 1/19/12 02:01 PM


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