Overseeing the collection, storage, and release of patient health information.
The Health Records Department at Windsor Regional Hospital retains and manages patient records according to government legislation which means the hospital may keep only some of your records.
ALL patient information is confidential. Access to the specific details regarding your illness and treatment are restricted to the members of your health care team.
Frequently Asked Questions
Requests for copies of your Health Records can be made through your physician or you can make a personal request. We recommend placing the request through your physician who can then discuss the contents of the Health Record with you and provide clarification as required.
To request a copy of your records, you must submit a dated, written and signed request with a completed copy of the form below.
Form to request personal information
The request must include:
- Authorization directed to Windsor Regional Hospital;
- Patient’s name;
- Patient’s date of birth;
- Reason for the request;
- Type of information required and the treatment or admission dates; and
- The name and address of the individual you wish the information to go to.
The Authorization for Release of Patient Information Form must:
The Authorization for Release of Patient information is valid for 90 days after it is completed.
- Be dated;
- Be signed by the patient or a substitute decision maker if the patient is 16 years of age or older;
- Be signed by the parent of legal guardian if the patient is 16 years of age or younger;
- Be signed by the substitute decision maker if the patient is incapable of signing. Proof of legal signing authority must also be submitted;
- Be signed by the executor if the patient is deceased. Proof of executorship must also be submitted;
- Be witnessed and signed by one other person.
Mail or deliver your requests to:
Windsor Regional Hospital
Health Records Department
1995 Lens Avenue
Photo ID is required
When picking up copies of health records picture ID is required. Records cannot be released without proof of identification and a signed Authorization for Release of Patient Information.
No we do not accept requests or enquiries via email or fax.
Please allow approximately 3 (three) weeks for the preparation of the records being requested.
If mental health information is being requested you are also required to complete a Form 14, which is available through the Health Records Department.
For patients who are incapable of signing consent, a Substitute Decision Maker can make the request. Proof of legal signing authority must also be submitted with the request.
For patients who are deceased, the Estate Executor can make the request. Proof of Executorship must be submitted with the signed request.
There is no charge to send copies of your records to your physician.
An administrative fee may apply for the search, preparation and copying of the records requested. The fee must be submitted with your request.
A proof of birth letter can ONLY be provided to the mother of an infant (with picture ID for proof of identification) without a completed Authorization for Release of Patient Information signed by the mother. Proof of Birth is provided free-of-charge for less than or equal to 6 months. After this time an administrative fee will be applied. Please note this proof of birth letter is not a birth certificate and cannot be used as a birth certificate.
For additional information, please contact the Release of Information Clerk:
519-254-5577 ext. 52313
519-254-5577 ext. 33191