Medical Records and Privacy Practices

Request a Copy of your Medical Records

If you are an active patient and would like a copy of your medical records mailed to a physician or yourself, fill out, sign, and send an Authorization for Release of Medical Records Form by fax at (302) 322-6201 or mail to the site where you receive care (address below). Requests are normally processed within 7-10 business days.

Authorization for Release of Medical Records Form

You can request a copy of your medical records if you are a:

parent or legal guardian of a patient under the age of 18
patient under the age of 18 with legal rights to consent for him/herself
patient 18 years and older
legal guardian of a patient 18 years or older with written patient consent
legal guardian of a patient 18 years or older who doesn’t have the capacity to consent

Request Another Individual to Access Your Medical Information

To submit your request, you must fill out, sign, and send an Authorization for Release of Information/or Coordination of Care for an Adult Patient Form by fax at (302) 322-6201 or mail to the site where you receive care (address below).

You can grant another individual access to your medical information if you are:

patient 18 years and older
legal guardian of a patient 18 years or older with written patient consent
legal guardian of a patient 18 years or older who doesn’t have the capacity to consent

Authorization for Release of Information/or Coordination of Care for an Adult Patient (English)

Authorization for Release of Information/or Coordination of Care for an Adult Patient (Spanish)

Request Form Completion Consent

If you have a form that needs to be completed by your healthcare provider outside of a scheduled appointment, such as for FMLA, sports or school physicals, or health insurance, please complete the Request for Form Completion Consent Form. Fax at (302) 322-6201 or mail to the site where you receive care (address below).

Request for Form Completion Consent Form

Request Partial Information

For requests for partial information such as a copy of your or your child’s immunization records, physical, lab, or procedure results, etc., please contact the Medical Records Department at the medical office where you receive care.

Medical Records Contact Information

Site	Address	Phone
4^th Street	1802 W. 4th Street, Wilmington DE 19805	(302) 655-5822
Bear	404 Fox Hunt Drive, Bear, DE 19701	(302) 836-2864
Dover	1020 Forrest Avenue, Dover DE 19904	(302) 678-4622
Newark	27 Marrows Road, Newark, DE 19713	(302) 455-0900
Northeast	908-B E. 16th Street, Wilmington, DE 19802	(302) 575-1414

Patients – press options 4, 3, then 5

Healthcare providers – press options 4, 5, then 6

Medical Records Fax: (302) 322-6201

Request Complete Copies of Medical Records

Westside uses a 3rd party for requests to law offices, disability, insurances, other healthcare facilities or patients who request all records. If your records have not been received please contact these parties.

To get an update on the status of your request, contact Medical Healthmark Group at (800) 659-4035.

Privacy

As a part of our effort to provide quality healthcare for the entire family, Westside Family Healthcare is committed to protecting the privacy of our patients, in accordance with the Health Insurance Portability & Accountability Act of 1996 (HIPAA).

Below you will find a link to Westside Family Healthcare’s Notice of Privacy Practices. This Notice is provided to all patients who receive care at Westside Family Healthcare’s offices. It explains how we may use and disclose a patient’s personal health information. The Notice also explains a patient’s rights in respect to personal health information, and how a patient can report a suspected privacy protection violation.

Westside Family Notice of Privacy Practices

If you have any questions about this notice, please contact Lourdes Shea, Director of Site Operations at 302-652-2455 ext. 1330.