Your medical records are a collection of documents that represent your visits and treatment at Shore Medical Center. Health information management services staff are trained to ensure that this information is complete, confidential and accessible to you. The privacy and confidentiality of your records is protected by law.
Medical Record Requests
To request your health information, please complete the form "Authorization to Use/Disclose Protected Health Information (PHI)" and mail to:
Health Information Management Services Shore Medical Center c/o Release of Information 100 Medical Center Way, Somers Point, New Jersey 08244
- Download Authorization to use and Disclose in English
- Download FAQ in English
- Download Authorization to use and Disclose in Spanish
- Download FAQ in Spanish
A valid authorization MUST contain the following information or the request will be returned:
- Patient's full name and date of birth (any other names if applicable)
- Specific information being requested (i.e. date of service, type of report)
- Purpose for which the information may be disclosed (i.e. person, attorney, physician)
- To whom the information is to be sent (name and address)
- The patient's signature or a patient's legal representative's signature.
Authorizations signed by a representative must be verified.
Please include a copy of one of the following documents indicating either:
- Legal guardianship papers
- Advance Directive/Healthcare Power of Attorney
- Designation of Personal Representative, which allows the representative to act on the patients behalf with regard to personal health information.
- Date of the signature
- Please note unsigned requests will not be processed
To contact Release of Information, please call 609-653-3243 or 609-653-3614, Monday through Friday, 7:30 a.m.- 4:00 p.m.
Frequently Asked Questions
- Who can obtain copies of my records?
Records can be released to anyone who the patient authorizes (in writing) to receive such information. When the authorized representative wants to obtain the record on the patient's behalf they must present a document or a letter from the patient giving permission to do so or the authorized representative must have proof of legal power of attorney. In situations that involve minors (17 years of age and younger) the parent or guardian would be the authorized representative.
- What if I'm unsure of the exact date(s) I was treated?
You should provide as much information as possible (i.e. date and/or year, time of year, type of injury) to assist us in the search. With this information health information management services will make a concerted effort to find the requested information.
- How long will it take for my request be processed?
Health Information Management Services (HIMS) makes every effort to process requests expeditiously. The New Jersey state regulation allows up to 30 days from the date of the request to comply with any request to release information.
- Is there a fee for requesting a copy of my medical records?
There is no fee when the records are being requested for further treatment or continuity of medical care. However, there is a charge of $1.00 per page for records provided for the patient's personal use, legal purposes and/or similar intent. The patient will be advised of the actual charges when the request is processed. Estimates will be provided upon request. Payment is expected when the records are mailed or picked up.
HIMS business partner is Medical Record Online (MRO). They are responsible for the billing and mailing of requested records. You may receive an invoice on their business letterhead. Once payment is made to MRO, the records will be mailed. If you have questions related to the invoice, please call the phone number listed on the invoice.
- Is identification needed to obtain/pick up records?
Identification is always required. A photo ID is preferred. For those situations when a patient is authorizing release of records to third party on their behalf, the third party must present identification. Please note, documentation of the patient's mailing address is needed if different from the one on file at Shore Medical Center.
- When can I come to pick up the records I requested?
In person requests for release of information and pick-up will only be handled during normal business hours which are Monday through Friday, 7:00 a.m.- 3:00 p.m. (closed on holidays). In an effort to protect patient confidentiality and privacy, records will not be faxed unless there is a bonafided medical emergency. Emergent requests will be handled on a case by case basis.
If you have additional questions regarding the release of medical records call, 609-653-3243 or 609-653-3614, Monday through Friday, 7:30 a.m - 4:00 p.m. (closed on holidays).