HIM Release of Information - UC Davis Health 2025

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UC Davis Health's Health Information Management department will virtualize all Release of Information services effective April 1st, 2022, moving to a new location in Mather. Front desk services will no longer be available, and patients can submit requests for their medical records via email, fax, or mail. Additional information is available on their website.

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Click ‘Get Form’ to open the HIM Release of Information in our editor.
Begin by entering your personal information in the designated fields: Patient Name, Date of Birth, and UC Davis Health Medical Record Number.
Fill in your address details including Street Address, City, State, and Zip Code. Providing a phone number and email is recommended for efficient communication.
Specify the name of the person or facility authorized to release your health information along with their address.
Indicate the type(s) of health information you wish to be released by checking the appropriate boxes. You can also specify a date range for the records.
Select your preferred delivery option for receiving the information, such as US Mail or electronically via secured email or MyUCDavisHealth.
Review all entered information for accuracy before signing and dating the authorization at the bottom of the form.

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Versions	Form popularity	Fillable & printable
2022	4.2 Satisfied (46 Votes)
2011	4 Satisfied (22 Votes)

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What is the meaning of release of information?

An ROI is a form authorizing doctors to share a patients files. Without a signed ROI, providers cannot legally disclose medical details, even if sharing could help. The ROI allows care team membersdoctors, nurses, specialiststo communicate about treatment. This ensures all involved are aligned for coordinated care.

What does release of information mean in healthcare?

In medical terms, ROI stands for Release of Information. Release of Information balances the need for accessible health data with protecting patient privacy. It also ensures that your sensitive medical information is shared appropriately, securely, and in compliance with legal standards.

What is release of information in healthcare?

Release of information means the dissemination of confidential information with consent.

How to fill out authorization for release of health information?

How do I fill out a HIPAA release form? Provide instructions. Name the patient and individual authorized to use or disclose their PHI. Describe the information. Specify recipients. Specify the purpose of disclosure. Specify the time period. Detail their revocation rights. Obtain the patients signature.

How do I get my UC Davis medical records?

You may email hs-roi@ucdavis.edu for medical records or ucdhsimagerequest@ucdavis.edu for radiology images to check the status or if you are experiencing technical issues retrieving records that you received. Please be sure to include name and date of birth of the patient so that we may better help with your request.

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Who is authorized to release patient information?

The Privacy Rule allows those doctors, nurses, hospitals, laboratory technicians, and other health care providers that are covered entities to use or disclose protected health information, such as X-rays, laboratory and pathology reports, diagnoses, and other medical information for treatment purposes without the

What does signing a release of information mean?

Under the California Confidentiality of Medical Information Act (CMIA), patient medical records may not be disclosed without authorization unless disclosure is required for litigation or is required to communicate important medical information to other healthcare providers, insurers, and other interested parties.

HIM Release of Information - UC Davis Health 2025

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What is the meaning of release of information?

What does release of information mean in healthcare?

What is release of information in healthcare?

How to fill out authorization for release of health information?

How do I get my UC Davis medical records?

Complete this form in 5 minutes or less

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Who is authorized to release patient information?

What does signing a release of information mean?

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