We share our suggestions for ordering neurological records from Kaiser Permanente Colorado.
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
KAISER PERMANENTE COLORADO INFORMATION
These suggestions are derived from speaking with staff from the medical records office and viewing helpful webpages, including:
Records, forms & certifications | Kaiser Permanente
If you are the intended donor, or the intended donor’s legal representative and have access to the Online Patient Portal, Kaiser recommends that you use options #1, or #2.
1. Download a summary of records via the online patient portal.
Note: The summary may not provide a complete medical history. We suggest you review before downloading.
Downloaded records may be submitted to Mayo Clinic by:
- Secure email to Dennis Dickson, MD, ℅ the Brain Bank Coordinator, Rachel LaPaille-Harwood, at [email protected]
- Post to Google Drive, Box, or other online file sharing service with a link to the file(s) sent via email to the Brain Bank Coordinator, Rachel LaPaille-Harwood, at [email protected]
- Fax to Dennis Dickson, MD, (fax 904-953-7117)
- US Mail to Dennis Dickson, MD, Mayo Clinic Jacksonville, Birdsall 310, 4500 San Pablo Road, Jacksonville, FL 32224-1865 (phone 904-953-2439)
2. Order an electronic copy of detailed medical records. You can order records by completing an online request once you sign into Kaiser’s online patient portal account. You can specify the date range, which medical records, and the party receiving the copy of your medical records. Your request will be processed within 5 business days. (Note: Note that Hospital and Medical Office records released as part of this request may contain references related to mental health, addiction, and HIV conditions.)
You can request the records be sent directly to Mayo Clinic (see above), or if you elect to receive a copy of the records, you can then forward the records via email to the brain bank or post the records to the cloud for the brain bank to download.
3. Request medical records be sent directly to the Mayo Clinic. Kaiser has its own Authorization For Use Or Disclosure Of Patient Health Information form. Provide as much information as possible on the form, such as:
-> Section 2. Kaiser Permanente may release this information to:
Please enter Mayo’s information as follows:
Dennis Dickson, MD, Mayo Clinic Jacksonville
4500 San Pablo Road, Birdsall 310
Jacksonville, FL 32224-1865
Phone: 904-953-2439
Fax: 904-953-7117
Email: ℅ Rachel LaPaille-Harwood: [email protected]
-> Section 3 This disclosure can be used for the following purpose(s):
Check the box for “Medical Condition Verification”
-> Section 4 Check ONLY one of the following three options to identify the health information to be released and be specific.
Check the box for option #3.
IIn step #1…provide the date range for the time the patient was seen, in the fields provided. (If you do not know exact dates, you may use a broad range to capture all the appointment data.)
In step #2…check the box for ALL RECORDS. You may also check the box for Other (provider, department, specialty) and provide the specific specialist(s) name to ensure those records are included, or write “all neurologically-related records”.
-> Section 5 Check the boxes below if you want this release to include the following information, Otherwise, this information will be excluded.
If applicable, check the box for:
- Genetic testing records
- Mental Health Treatment records
-> Section 6 Media Type and Delivery Preference:
Please check the box for “electronic” in both Media Type and Delivery Preference to ensure the safest and quickest delivery.
Be sure to sign and date the form. Unsigned forms will not be accepted.
If the intended donor is not able to sign the form, the medical power-of-attorney should sign his/her name. When you email or fax the completed authorization form, include the medical power-of-attorney document. (We highly encourage a follow up call to the Release Of Medical Information (ROMI) department (phone 303-404-4700) within 5 -7 business days to ensure the request has been processed, ask and record the date the request was completed and by what method it was sent to Mayo Clinic. This information will come in handy if Mayo has issues receiving the medical records.)
You may submit the completed form by one of the following methods:
- Email to [email protected]
- Fax to 303-404-4750
- Mail to Northfield Support Services, Attn: Release of Information, 11000 E. 45th Avenue, Denver, CO 80239-3004