We share our suggestions for ordering neurological records from Stanford.
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
STANFORD INFORMATION
These suggestions are derived from speaking with staff from the medical records office and viewing helpful webpages, including: Medical Records | Stanford Health Care
To summarize that webpage:
1. Download records through MyHealth online patient portal.
Downloaded records may be submitted to Mayo Clinic by:
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Secure email to Dennis Dickson, MD, ℅ the Brain Bank Coordinator, Rachel LaPaille-Harwood, at LaPaille-Harwood.Rachel@mayo.
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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.
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Fax to 904-953-7117 (Attn: Dennis Dickson, MD)
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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 records by completing an online request by logging into MyHealth and completing the “Request Your Medical Records” form located under My Medical Records>Request Records. As a patient, you or your legal representative may obtain a copy of your medical records (and forward to Mayo Clinic yourself) or have copies of your medical records sent directly to Mayo Clinic by one of the following methods:
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Secure email to Dennis Dickson, MD, ℅ the Brain Bank Coordinator, Rachel LaPaille-Harwood, at LaPaille-Harwood.Rachel@mayo.
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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 LaPaille-Harwood.Rachel@mayo.
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Fax to Dennis Dickson, MD, (fax 904-953-7117)
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US Mail to Dennis Dickson, MD, Mayo Clinic Jacksonville, Birdsall 310, 4500 San Pablo Road, Jacksonville, FL 32224-1865 (phone 904-953-2439)
Your request will be processed within 5 business days.
3. Call Stanford Health Information Management department (HIM phone 650-723-5721) during normal business hours Monday through Friday, 8:00 a.m. to 5:00 p.m. and HIM may take your request over the phone. Once completed the medical records will be sent to the email address on-file (associated with the patient’s account). Your request will be processed within 5 business days. Then you can forward the records via email to the brain bank or post the records to the cloud for the brain bank to download.
4. Complete a health information release form, and fax or mail the completed form to Stanford HIM. (Links for English and Spanish versions of the Authorization for Use or Disclosure of Protected Health Information form can be found under the section Titled “How to request a copy of your medical records”.) The authorization form must be completed thoroughly, dated and signed. Provide as much detail as possible when completing the form, including dates of service and/or the names of providers. (Note: Requests must be specifically signed if requesting/authorizing the release of records for psychiatric care). Your request is processed within 14 days.
Things to know about the authorization form.
-> Section B: Authorization. The Stanford Health Care mailing address on the form (300 Pasteur Drive, Stanford, CA 94305) is a general mailing address and your request will be forwarded to the HIM department. To avoid delay, use the mailing address listed on the medical records webpage to reach the HIM department directly, Stanford Health Care, Health Information Management Services, Attn: Patient Records, 430 Broadway, Mail Code 6330, Redwood City, CA 94063.
-> Section C: The Health Information. Any selection with a box checked must also be initialed or the request will not be processed.
-> Section D: Delivery formats. The most expeditious method to forward the records to Mayo is by having the records sent by electronic format (PDF) to the secure email of the Brain Bank Coordinator, Rachel LaPaille-Harwood, at LaPaille-Harwood.Rachel@mayo.
-> Section E: Reason. This section must be completed. If left blank, the request will not be processed. When checking the second box, you may use any of the following examples as a reason for release: “medical research,” “clinical-pathological correlation” or “brain bank research.”
-> Section F: Expiration. You may leave this field blank and the expiration of your request will be one year from the date received. A common mistake made is to put today’s date in when completing the form which makes the request void as soon as it’s received, and Stanford will not process the request. Be sure to use a future date when completing this section.
-> If the intended donor is signing the form, return it via fax (fax 650-725-9821) or US mail (Stanford Health Care, Health Information Management Services, Attn: Patient Records, 430 Broadway, Mail Code 6330, Redwood City, CA 94063) along with a legible copy of a driver’s license or state ID card.
–> If the intended donor is not able to sign the form, the medical power-of-attorney should sign his/her name. When you fax or mail the completed authorization form, include the medical power-of-attorney document and a photograph of the medical power-of-attorney’s government-issued ID.
–> We suggest a follow up call to Stanford Health Information Management (phone 650-723-5721) within 3 -5 business days 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.