Inpatient Records

Mission Statement:

Services Provided:

Requesting Information:

Patients may request copies of their medical records using form DD Form 2870 (Authorization for Disclosure of Medical or Dental Information) available online www.dtic.mil/whs/directives/infomgt/forms/formsprogram.htm either by mail or by visiting ROI reception, located on the second floor, Patient Administration, Room A26. Duty hours: Monday-Friday, 0800-1630 hours, excluding holidays.

The ROI office provides copies of official medical records.

Requests for inpatient records, and most outpatient records, take a minimum of 30-45 days to process.

Newly established inpatient records cannot be copied until they are assembled, coded and signed by the provider. Please allow 30-45 days after discharge for completion of your request.

Department of Behavioral Medicine and sensitive records must be reviewed and cleared by a provider before release. Please allow up to 30 days for processing.

The following record requests can normally be processed same day as a walk-in:

• Laboratory Tests (excluding HIV results or any other sensitive results, see Ordering Provider or Preventive Medicine)
• Radiology Tests
• EKGs
• Electronic Physician notes

All requests for information must include the following:

• Patient's name
• Patient's date of birth
• Sponsor's complete social security number
• Period of treatment/information needed
• Statement authorizing BJACH to release the records to a specific person/organization
• An address and/or phone number of the receiving person/organization
• The purpose for the release of the information
• Expiration Date
• Mail/Fax request must include front and back copy of picture ID

Patient's signature/date - Patients who are 18 years and older, or emancipated, must sign an authorization for release of their medical records.

Exceptions:

Minor children, physically, or mentally challenged persons. A parent or legal guardian may request copies with appropriate documentation: Medical Power of Attorney, copy of the court order appointing guardianship, if applicable. AR40-66

Deceased patients - The patient's surviving next of kin (NOK) or a court appointed executor/administrator signs consent. A copy of the death certificate must accompany all requests. Executors/administrators must show legal documentation appointing them to the position. AR40-66

Legal Release of Information Mission - To provide medical information to our customers in a prompt, professional manner, while protecting patient's privacy and ensuring each request is releasable in accordance with State and Federal laws.

All other requests must be accompanied by a Subpoena or signed by a judge who specifically indicates release of medical records.

Contact: Legal ROI Technician – (337) 531-3934

Preparing to Retire or Separate:

Active duty members preparing to retire or separate should obtain copies of all medical records at least one month prior to their final out processing date.

Members should return to ROI to obtain copies of medical paperwork generated after their records were initially copied. This will ensure members get a complete copy of their Active Duty Medical record after their retirement/ separation.

Individuals are entitled to one (1) free copy of their medical record per life-time of the record, to include periodic updates. Additional copies can be obtained for a $2.00 cost per CD or a $12.00 flat rate plus .15 cents per page.

Civilian Records:

For continuation of care within BJACH, ROI will retrieve medical records from a civilian facility at the patient’s request. Once these records arrive at BJACH, they are filed into the patient’s outpatient record. All information filed into outpatient record becomes property of the DOD.

If you need medical documentation for your personal record, you will have to go to the treating facility and submit a request through their records section.