ST. CHARLES SURGICAL HOSPITAL Home Your Team About Testimonials News Contact Us BreastCenter.com COVID-19 MEDICAL RECORD REQUESTS Patients As a patient, you are entitled to obtain copies of your medical records. Here are instructions and guidelines for submitting the St Charles Surgical Hospital authorization form for your personal records. Please note we can release only those records that pertain to hospital stay. To receive a hard copy of your medical records, please follow these steps: Please download and print the PDF release form You must print legibly so we can easily find your requested records All sections must be completed for us to provide your records A complimentary abstract of your hospital record will be provided at no charge and includes the following documents: H&P, Pathology report, Operative report, Labs, and Radiology Reports and other diagnostic results. All other requests may be assessed a fee based on the quantity and formatting of documents to cover handling, supplies and postage. Return the completed form by Mail, Fax, or Email Mail St Charles Surgical Hospital 1717 St Charles Avenue New Orleans, LA 70130 FAX Medical Records Release 504-564-7408 Email Recordsrequest@scsh.com Please allow us 7-15 working days after we receive your request to prepare the records. Even though Louisiana law gives us 30 days, we will make every effort to honor your time frame. Once your request is prepared, you may pick up your records in person or we will mail them to you, whichever option you selected on the form; fax service is available only if you want your records sent to another health care provider. Records may be mailed out of town. If picking up records in person, please be prepared to present your photo ID. We can only give copies to the person designated to receive the records in the authorization. A member of our staff will call to plan for pick-up at the registration desk. Our office hours are 9:00 a.m. to 4:30 p.m., Monday through Friday. If you are signing for another adult person, you will need to provide us with a copy of the patient’s Durable Power of Attorney for Health Care. In the State of Louisiana, a general Power of Attorney does not cover release of medical records. If you are signing on behalf of the patient, you must identify your relationship to the patient at the bottom of the form and indicate your authority to sign. If there are any issues, our Release of Information office will give you a call. Please note that Parents may not request records for children age 18 or older without a valid Durable Power of Attorney for Health Care. IF YOU have additional questions or FIND AN ERROR IN YOUR MEDICAL RECORD you may contact a Medical Records staff member at 504-529-6692. Facility or Doctor As a facility or provider, we are happy to assist you with medical record documents necessary for continuing treatment for a mutual patient. Here are instructions and guidelines for requesting records from St Charles Surgical Hospital or the Center for Restorative Breast Surgery: To expedite release of medical records, please follow these steps: Please fax the request on a document that clearly identifies the facility and/or provider to receive the records. The patient’s name and date of birth must be included. Provide a FAX and Phone number for questions we may have about the request. Send the request to fax number (504)-564-7408. You must print legibly so we can easily find the requested records. Please Specify the date of service and the specific documents needed We make every effort to expedite records for continuing treatment as needed at no charge. Please allow us 7-15 working days after we receive your request to prepare the records. Even though Louisiana law gives us 30 days, we will make every effort to honor your time frame. To follow-up on a request please call us at 504-529-6692 Our office hours are 9:00 a.m. to 4:30 p.m., Monday through Friday. 1717 ST. CHARLES AVENUE NEW ORLEANS, LA 70130 FACEBOOK | LEGAL DISCLAIMER | DATA COLLECTION PRIVACY POLICY | SITEMAP COPYRIGHT © 2010-2021 ST. CHARLES SURGICAL HOSPITAL, LLC. A PHYSICIAN OWNED HOSPITAL. ALL RIGHTS RESERVED.