Request for amendment to medical record

As a patient, you have a right to request an amendment (correction/changes) to your medical record if you believe the information is incorrect or incomplete. The amendment should include the information you believe is in error and your corrections to that information.

How do I request an amendment to my medical records?

• You will need to submit a completed Amendment Request form (pdf). The form must be signed and verification of identity is required.
• If using a Chrome Operating System, you must first download and save the form, then re-open it before you can enter data into the fields.
• The form can be submitted by email, fax, mail or in person.
• Email to HIM Integrity Team at HIMIntegrityTeam@HF.org
• HIM location addresses and fax numbers are included on the form.

How long will it take for my medical records to be corrected?

• The instructions will include the timeline of the process and how you will be notified if the amendment has been accepted or denied.

What if I only need to make demographic changes, for example, name change and/or address change?

• Changes to demographic information (for example, name, date of birth, address, etc.) in your medical record do not require the request form. You may request a change to this information by contacting Patient Business Services.