We share our suggestions for ordering neurological records from USF Health (University of South Florida).
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
USF HEALTH INFORMATION
These suggestions are derived from speaking with staff from the medical records office and viewing helpful webpages, including:
USF Health: Electronic Health Records
If you are the intended donor or the intended donor’s legal representative, there are two ways to order health records from USF Health.
1. Order records by completing an online request via the USF Health Wizard.
This 2-minute tutorial summarizes how to submit an online request and explains how to verify your identity with your computer, smart phone, or tablet’s camera and a photo ID.
Once records have been emailed to you, they 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. Complete the USF Health Release of Information form. Please provide as much information as possible on the form, such as:
-> Release 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, email [email protected]).
-> Obtain from – Write in the specialist(s) names, clinic address. You may need to complete separate ROI forms if specialists were seen at multiple clinic addresses.
-> Purpose of requesting records – Write in “Medical Research.”
-> Authorization to disclose PHI – In section A, initial next to “Records of the treating physician” and write in the specialist(s) name(s). Also initial next to “Labs or pathology” and “Radiology report or images.”
-> Expiration of Authorization – If you leave this section blank, the expiration date will be one year from the date the request was received. If you provide a date in this section, please use a future date. (A common error is to enter the date you are signing the form. This invalidates the authorization form immediately, and it will not be processed.)
–> If the intended donor is not able to sign the form, when you fax the completed authorization form, it is also a good idea to fax a copy of the medical power-of-attorney document or advance directive as well.
Submit to USF Health by fax to 813-974-4280 or 813-821-8382.
If you do not receive an email notification (or cannot locate it), we highly encourage a follow up call to USF Health Release of Information office (813-821-8911 or 813-974-8918) 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 for tracking purposes.
You should receive your records within 10-15 working days. Unsigned or incomplete authorization forms will not be processed.