We share our suggestions for ordering neurological records from UCSD (University of California San Diego).
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
UCSD INFORMATION
These suggestions are derived from speaking with staff from the medical records office and viewing helpful webpages, including:
Medical Records at UC San Diego Health
If you are the intended donor, or the intended donor’s legal representative and have access to MyUCSDChart, option #1 is recommended.
1. Download records online via MyUCSDChart.
Log in to MyUCSDChart. If you do not have a MyUCSDChart account or an activation code, call MyChart Support at 619-543-5220 for assistance, daily from 6 a.m. to 10 p.m. If you are not the patient, MyChart Support can provide assistance to only if there is a healthcare power-of-attorney (POA) document on file with UCSD Health.
Go to Menu (top left) and choose Medical Records (in the My Records section).
Choose Medical Record Request and follow the prompts.
Records will be delivered to your MyUCSDChart account, usually within three business days. (Records that require a provider’s approval for release may take longer.)
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.
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 [email protected]
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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 with the online request form. (This method does not require MyUCSDChart patient portal access.)
The self guided online form will walk you through each question step-by-step.
If you are the patient, have a copy of your government issued photo ID ready, as you will be asked to upload the copy to attach to your request.
If you are the patient’s representative, have a copy of your government issued photo ID ready, and supporting documentation (i.e. copy of the patient’s advance directive, or healthcare-power-of-attorney) to upload and attach to your request.
There is no charge for records to be sent to another health care provider. Records released directly to the patient or an authorized family member may be subject to charges.
Note, you must have a U.S. address, an email address, or a physical address to receive the copies, otherwise you will be referred to UCSD Health’s third party provider (MRO Corp.) for alternatives to request your records.
If you receive records directly, forward them to the brain bank via email or post them to the cloud for the brain bank to download.
To request scans and other imaging, contact Radiology/Imaging Services at 619-543-6586. (Note that Mayo only needs imaging reports, not the images themselves.)
3. Complete the UCSD Health Authorization To Release Protected Health Information form.
Please provide as much information as possible on the form, such as:
-> Record Holder – Check the box for UC San Diego Health
-> Release Records to – Dennis Dickson, MD, Mayo Clinic Jacksonville, Birdsall 310, 4500 San Pablo Road, Jacksonville, FL 32224-1865 (phone 904-953-2439, fax 904-953-7117)
-> Purpose – Check the box for “Other” and use any of the following examples as the purpose for release: “medical research,” “clinical-pathological correlation” or “brain bank research.”
-> Health Information to be Released – It is important to include the date range next to “Dates of Service”. If you do not recall specific dates, use a broad date range to capture all the visits/appointments. Be sure to include an actual ending date.
Check any/all boxes that may apply. (Note: Mayo will want any reports from scans, images, or testing but does not need the actual images themselves. If this applies, then check the box for “Hospital Stay” to obtain these reports.) You may also check the box for “Other” and add “All neurologically-related reports”.
Under delivery method check the box for “Mail” or “Email”. (Note: Email is preferred, however UCSD Health has a limitation on email size. If there are more than 3 visits, please check “Mail”.)
-> Sensitive Information – You must initial the blank field next to the pertinent record description for UCSD to release sensitive information. If applicable, check the box for:
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Mental Health/Psychiatric treatment records
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Genetic Test Results
-> If the intended donor is not able to sign the form, the legal representative should sign and date the form. When you fax or mail the completed authorization form, UCSD Health requires a copy of the medical power-of-attorney document or advance directive as well as a copy of your government-issued photo ID.
Submit the completed form to UCSD Health Information Management Department by:
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Fax 619-543-7128, or
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Mail: UC San Diego Health, Attn: Health Information Management, 200 West Arbor Drive, #8825, San Diego, CA 92103
Unsigned or incomplete authorization forms will not be processed.
We highly encourage a follow up call to UCSD Health Information Management (619-543-6704) two weeks after submitting the authorization form. Inquire when the records were sent (or will be sent) and by what method it was sent to Mayo Clinic for tracking purposes.
Requests will be processed within 15 days.