This form is used to certify the authenticity of medical records provided to the attorney by a medical provider.
Wisconsin Certificate of Authenticity of Medical Records
State:
Multi-State
Control #:
US-PI-0013
Format:
Word;
Rich Text
Instant download
Description
How to fill out Certificate Of Authenticity Of Medical Records?
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For paper copies: $1 per page for the first 25 pages; 75 cents per page for pages 26 to 50; 50 cents per page for pages 51 to 100; and 30 cents per page for pages 101 and above.
You can contact your doctor's office, clinic, or any other place you've received care to ask for your health records.
§ 51.30) generally requires informed written consent for the disclosure of mental health, developmental disability, and AODA ?treatment records? outside of the treatment facility where an individual is receiving treatment, except in situations involving medical emergencies posing an immediate threat to the health of ...
Generally, under Wisconsin law, your health care provider is required to keep your original medical record. However, you have the right to see and get a copy of it.
A physician or physician's assistant must maintain a health care record on every patient. The records must be kept for at least 5 years... Treatment records (for mental illness, and drug/alcohol abuse) must be retained for 7 years after the treatment has been completed. For...
(a) A patient's health care records shall be provided to the patient's health care provider upon request and, except as provided in s. 146.82 (2), with a statement of informed consent. (b) The health care provider under par. (a) may be charged reasonable costs for the provision of the patient's health care records.
