| |
|
 |
| |
Health Information & Forms
|
|
 |
 |
Patients’ Bill of Rights
As a patient in a hospital in New York State, you have the right, consistent with law, to ...
Patients’ Bill of Rights (PDF)
HIPAA Privacy Notice
Protecting our patients’ medical information is a priority at St. James Mercy. The notice below describes how medical information about you may be used and disclosed and how you can get access to this information.
HIPAA Privacy Notice (PDF)
Medical Record Request
Patients can request a copy of their health records by downloading and printing a copy of the Patient’s Request for Release to Protected Health Information form.
Authorization for Release of Health Information, HIPAA (PDF)
Mail or Fax the original, signed form to:
St. James Mercy Hospital
Attention: Health Information Management Services
411 Canisteo St., Hornell, NY 14843
Or Fax to (607) 324-8708
Please note – Health information cannot be mailed to patients’ homes. Picture ID is required at time of pick up, and there may be a charge for this request.
Universal Medication Form
It is important for you to have a record of the medications you are taking in an emergency. Please download and print the Universal Medication Form and fill it out for you or your loved one and carry it with you.
Universal Medication Form and Instruction Sheet (PDF)
Health Links
These online health resource websites are designed to help meet your health information needs and aim to provide general information about the topics they present. To search for health information, click on any of the following links.
www.WebMD.com
www.nlm.nih.gov/medlineplus/
Note: This information is general in nature and should not be relied upon as medical advice. The above organizations are not affiliated in any way with St. James Mercy Health System.
|
|
|
|
