Mackenzie Health
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Patients & Visitors - Services and Amenities - Personal Health Information



Medical Records

Hours of Operation

M-F 8:00am to 4:00pm


Phone and Fax

Fax: 905-883-2141   Tel: 905-883-2200



Room 1926, 1st Floor “B Wing”

Mackenzie Health

10 Trench Street

Richmond Hill, Ontario

L4C 4Z3


Collection of Personal Health Information

Mackenzie Health collects personal health information about you, directly from you or from the authorized person acting on your behalf. We are committed to our patients regarding the privacy of personal health information. For more information about our collection and privacy practices, please refer to our Privacy Statement


Release of Information

Under Ontario's Personal Health Information Protection Act, 2004 (PHIPA), you have a right of access to your own personal health information. Requests for access or disclosure to your personal health information can be made to Mackenzie Health the following ways:


To request access or disclosure to personal health information

Health Information Services

Release of Information

Mackenzie Health

10 Trench Street

Richmond Hill, Ontario

L4C 4Z3


In accordance with (PHIPA), Mackenzie Health has up to 30 days to process a request.

PHIPA Section 54.(2) Time for response

(2) Subject to subsection (3), the health information custodian shall give the response required by clause (1) (a), (b), (c) or (d) as soon as possible in the circumstances but no later than 30 days after receiving the request.  2004, c.3, Sched. A, s.54 (2).


Access to Mental Health information requires prior approval from the patient’s treating psychiatrist or the Chief of Psychiatry.


Consent Forms  Frequently Asked Questions  Fee Schedule


Frequently Asked Questions


How do I submit a request for legal or insurance purposes?

Release of personal health information for legal and insurance requests must be submitted via the legal or insurance representative.

The Release of Information team requires:

  • An original request letter from the legal or insurance representative stating what is needed
  • Original signed Consent for Disclosure of Personal Health Information form by the patient/client or substitute decision maker (if decision maker, please provide proof of authority to sign on behalf of patient)


We no longer require prepayment for legal or insurance requests.  Once a complete request is received, including the documentation noted above, the request is invoiced for the full amount.  The requested records are released when payment is received in full.


Is there a fee for requesting a copy of my own personal health information?

Yes.  For personal, legal and insurance requests there is an administrative fee of $30.00 and additional fees may apply depending on the request.  Please refer to the Fee Schedule.


How do I request a CD of my Diagnostic Images?

To request a CD of your Diagnostic Images:

Will the hospital have all my personal health information on file?

Mackenzie Health retains and manages personal health information according to relevant legislation and hospital policy.  Currently, we are responsible to keep patient records for 10 years.  If the patient was a child, the records are kept for 10 years past the year the patient reaches their 18th birthday.  Diagnostic images by law are kept for 5 years from the exam date.  If the Diagnostic image was of the breast then we must retain it for 10 years.  If the patient was a child the mentioned timelines apply once the patient has reached their 18th birthday.


I need my records urgently.  Is it possible to speed up the process?

Yes. We can fast track your request for personal health information for a STAT fee of $300.00 in addition to the routine administration fee.  These requests can be ready for release within two business days. 


Why do you require my consent before releasing my personal health information?

Personal health information is strictly confidential and belongs to the patient.  We are not able to release personal health information unless we have obtained written consent from the patient.  Written consent provides documented proof of the permission to release personal health information.


How do I request that my health information be released to another individual?

If you want your personal health information released to a relative, friend, family physician, specialist or another institution, you must:

  • Submit a signed, dated and witnessed Consent for Disclosure of Personal Health Information form giving Mackenzie Health authorization to release your information.  The consent is valid for 3 months (90 days).
  • Also provide a written note, signed and dated, permitting the named individual to receive the requested information.  The individual receiving the information on your behalf must show valid, government issued photo ID.

Do I need parental consent if I am a youth (15 years of age or under)?

Yes. Patients who are 15 years of age or younger must have both parents or legal guardians consent to the request on their behalf.  Patients who are 16 years of age or older are capable of requesting their own records and can consent to disclosing their health information.

Obtaining personal health information for child of minor age (<16yrs) if parents of minor are separated/divorced:

How do I request Proof of Hospitalization?

To request Proof of Hospitalization:

  • Complete the Consent for Disclosure of Personal Health Information form
  • Submit the request to Health Information Services with payment of $30.00 (as per the Fee Schedule)

How do I request Proof of Birth/Death?

To request Proof of Birth or Proof of Death letters:

  • Complete the Consent for Disclosure of Personal Health Information form
  • Submit the request to Health Information Services  with payment of $30.00 (as per the Fee Schedule)

How do I inquire about records for a patient who is deceased or incapable of signing consent?

In the case where the individual is deceased or incapable of signing consent, proof of estate trustee executorships or legal signing authority must be submitted with the request. The Power of Attorney does not have the right to access personal health information of a deceased patient.


How do I request a copy of a Death Certificate?

The hospital does not issue Death Certificates.  A Medical Certificate of Death is completed by the hospital and is sent to the funeral home with the deceased.  A Statement of Death is completed at the funeral home and the death is registered with the Office of the Registrar General.  To obtain a Death Certificate, please contact the Office of the Registrar General at 1-800-461-2156 or through the Ministry of Health and Long-Term Care website.


How do I request a correction to my personal health information?

Under PHIPA, if you believe your health information is incorrect, you have the right to request a correction to this information.

  • Complete and sign the appropriate Request for Correction to Personal Health Information form
  • Submit the request to Health Information Services for a full review.

How do I withdraw my consent to the use or disclosure of my personal health information?

You may withdraw consent for the release of personal health information or place conditions to any further use or disclosure of your personal health information.  The withdrawal of consent does not have retroactive effect nor does it affect the uses and disclosures of personal health information collected by Mackenzie Health where the use and disclosures are permitted or required by law without consent. Please see the Withdrawal of Consent form for more detail.

Fee Schedule


There is no charge to disclose your personal health information to another Physician or Health Care Provider in the Circle of Care.







Medical Records on CD


Providing a PDF copy of patient records on CD (encrypted)



$0.50 for each page


Medical Records paper copy


For making and providing photocopies or computer printouts of a record.



$0.25 for each page after the first 20 pages


Microfilm/Microfiche for records older than 2006



For making and providing a paper copy of a record from microfilm or microfiche


$0.50 per page


Verification Letters:


-       Birth

-       Death

-       Visit

-       Blood Type



Flat fee for any type of letter


No additional fees


Record Review


For supervising an individual examination of original records



$6.75 for every 15 minutes after the first 15 minutes


Record Review by a physician/clinician



For the review by a health information custodian or an agent of the custodian of the contents of a record to determine if the record contains personal health information to which access may be refused



$45.00 for every 15 minutes after the first 15 minutes


Diagnostic Images on CD



For making and providing Diagnostic Imaging (i.e. X-ray, MRI, CT scan)



$10.00 per CD


Urgent Request


Within two business days


$300.00, in addition to the standard applicable fee


WSIB (Workplace Safety and Insurance Board)






CPSO (College of Physicians and Surgeons)




$0.25 per page


CNO ( College of Nurses of Ontario)




$0.25 per page


Off-Site Retrieval





Clinical Trials

-       anonymous CD




$52.00 per CD




2012-13 - $4.28/chart

2013-14 - $4.37/chart

2014-15 - $4.46/chart

2015-16 - $4.56/chart

2016-17 - $4.69/chart

Mackenzie Health / 10 Trench St. Richmond Hill, On. L4C 4Z3 / Richmond Hill Line: 905-883-1212 or Vaughan Line: 905-832-4554 / TTY Service: 905-883-2123