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  • Release Of Medical Records Information - Avera Health

Get Release Of Medical Records Information - Avera Health

1325 S. Cliff Ave. P.O. Box 5045 Sioux Falls, SD 571175045 6053228000 AUTH REL Patient Identification Provider (Who is releasing information?) Release Information to (circle appropriate provider):.

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6053228000 Related content

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Related links form

DA 5699 2016 DA 5754 2004 DA 5840 1999 DA 5900 2013

Avera records Questions & Answers

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The short answer is most likely five to ten years after a patient's last treatment, last discharge or death. That being said, laws vary by state, and the minimum amount of time records are kept isn't uniform across the board.

MISSISSIPPI STATE LAWS: Complete medical records must be retained for a period of at least seven years for patients discharged at death, 10 years for adult patients of sound mind at the time of discharge, and for the period of minority or other disability plus seven years, but not to exceed 28 years for minors or ...

Personal medical records from visits to our county clinics must be obtained through our Epic service: call 601-576-7267.

The minimum required notification must: Identify the physician who treated the patient. Provide a general reason for the patient to be notified. Provide an explanation how to obtain medical records. Provide a HIPAA authorization for the patient to complete. State how long the records will be made available to the patient.

Call 205-930-7724 to request an Authorization for Use or Disclosure of Patient Information form. The form can be mailed to the address provided by the patient or faxed. Complete the Authorization for Use or Disclosure of Patient Information form and fax to 205-930-6721.

Patient records should be maintained a minimum of seven (7) years from the date of LAST treatment. Refer to Board Regulation 53.

For the most part, our medical records are confidential, and Mississippi law limits access to medical records to the patient. There are, however, some exceptions, like positive HIV tests, certain communicable diseases, and when a review board wants to evaluate the quality of a doctor's care.

It is permissible, based on the court's decision, to charge the statutory amount allowed by Alabama law - $1.00 per page for the first 25 pages, $0.50 for each page thereafter. However, you are not allowed to charge the search/retrieval fee of $5.00.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232