GENERAL GUIDELINES
As noted in our generic instructions for ordering neurological records from any institution, the brain bank:
- now requires that records be at the brain bank prior to the passing of the intended brain donor
- neurological records ONLY are needed. No primary care physician records or hospice records. In the cases of Parkinson’s Disease, only the most recent 6-8 years of records are needed.
- it is always easiest to download neurological records via the online patient portal. If you don’t have access to the online patient portal, records must be ordered from the medical records office or clinic. Records can be sent from medical records offices or clinics directly to the brain bank. One advantage of this approach is that there may be no fee to the family. One disadvantage of this approach is that the family has no real way to confirm that records have been sent.
- ideally, records should be sent to the brain bank by email or posted to the cloud for download by the brain bank. Second choice is by fax. Third choice is by mail with tracking. Last choice is by mail with no tracking.
- ordering records and following up with the medical records offices or clinics is the family’s responsibility
HOUSTON METHODIST HOSPITAL INFORMATION
These suggestions are derived from speaking with staff from the medical records office and viewing helpful webpages, including:
Medical Records | Houston Methodist
According to the Houston Methodist’s Medical Records and Privacy webpage, you can obtain medical records in five ways.
1. Download records through MyChart online patient portal.
Downloaded records may be submitted to Mayo Clinic by:
-
Secure email to Dennis Dickson, MD, ℅ the Brain Bank Coordinator, Rachel LaPaille-Harwood, at LaPaille-Harwood.Rachel@mayo.
edu -
Post to the cloud (Google Drive, Dropbox, Box, or other online file sharing service). Then email link to file(s) to the Brain Bank Coordinator, Rachel LaPaille-Harwood, at LaPaille-Harwood.Rachel@mayo.
edu -
Fax to 904-953-7117 (Attn: Dennis Dickson, MD)
-
US Mail to Dennis Dickson, MD, Mayo Clinic Jacksonville, Birdsall 310, 4500 San Pablo Road, Jacksonville, FL 32224-1865 (phone 904-953-2439)
2. Online Form: Complete the “Online (DocuSign) Patient Access Form” by clicking the link associated with the hospital where your loved one was seen. The hospital locations can be found at the bottom of the Houston Methodist Medical Records webpage:
houstonmethodist.org/medical-records
Once you have completed the form, “submit” to send to the selected location.
3. Not the Patient: If you are not the patient but would like to request medical records for a patient, download the Authorization for Use and Disclosure of Health Information form and mail, fax or email it to to the medical records department at the hospital where your loved one was seen. Hospital contact info can be found at the bottom of the Houston Methodist Medical Records webpage:
houstonmethodist.org/medical-records
The form must be filled out by the patient or the patient’s guardian/legal representative.
In the section, “To disclose/release the specified information below” please provide the following information for Mayo Clinic Jacksonville:
Dennis Dickson, MD
Mayo Clinic Jacksonville
Birdsall 310
4500 San Pablo Road, Jacksonville, FL 32224
Phone: 904-953-2439
Fax: 904-953-7117
Email c/o Rachel LaPaille-Harwood: [email protected]
4. Phone: Call the medical records department at the hospital where your loved one was seen. Hospital contact info can be found at the bottom of the Houston Methodist Medical Records webpage:
houstonmethodist.org/medical-records
5. PDF Form: Print and complete the Patient Access Form PDF and send via mail, fax or email to the medical records department at the hospital where your loved one was seen. Hospital contact info can be found at the bottom of the Houston Methodist Medical Records webpage:
houstonmethodist.org/medical-records
Note: In the section provided for the contact number of recipient, please provide the following information for Mayo Clinic Jacksonville:
Dennis Dickson, MD
Mayo Clinic Jacksonville
Birdsall 310
4500 San Pablo Road, Jacksonville, FL 32224
Phone: 904-953-2439
Fax: 904-953-7117
Email c/o Rachel LaPaille-Harwood: [email protected]
–> It is best if the intended donor signs the form. If the intended donor signs, return the signed form via email, fax, or US mail to the facility where services were rendered. Houston Methodist requires a copy of a state-issued photo ID.
–> If the intended donor is not able to sign the form, the medical power-of-attorney should sign his/her name. When you email, fax, or mail the completed authorization form, include the medical power-of-attorney document and a copy of a state-issued photo ID.
-> We suggest a confirmation call to the Houston Methodist Health Release of Information/Medical Records department where the request was submitted three to five business days after submitting the authorization form. Inquire when the records were sent (or will be sent) and confirm the delivery method – whether by secure email, fax or mail. Make a note of the date and method of delivery.
Your request is typically processed within 5-15 business days.