We share our suggestions for ordering neurological records from Raleigh Neurology Associates.
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
VETERANS ADMINISTRATION (VA) INFORMATION
These suggestions are derived from speaking with staff from the medical records office and viewing helpful webpages, including: How To Get Your Medical Records From Your VA Health Facility | Veterans Affairs
If you are the intended donor or the intended donor’s legal representative and have access to a Premium My HealtheVet account, options #1 or #2 are recommended.
1. Download records through My HealtheVet online patient portal. (https://www.myhealth.va.gov/mhv-portal-web/home)
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 records by completing an online request via the VA patient portal.
You may submit an online request for detailed medical records via the VA patient portal. Once completed, the detailed records file will be made available in the patient portal account. You may then download a copy of the medical records. (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.)
3. Complete the VA health Form 10-5345a. You may complete a health information release form, and submit the completed form to the VA Release of Information department by fax or mail.
Follow these steps to find contact information for your VA health facility’s medical records office:
a) Your VA health facility
b) On your health facility’s website, scroll to the “In the spotlight” box.
c) Select “Access your health records.” This will bring you to a page with contact information for the medical records office.
Unsigned or incomplete authorization forms will not be processed. Please provide as much information as possible on the form, such as:
-> To: Fill in the name and location of the VA medical center where the patient was seen.
-> Description of Information Requested – Check the following:
- “Progress Notes” – Select the appropriate option (Specific Clinics, Specific Providers, or Date Range for all clinics/providers) and provide the requested names and/or dates.
- “Lab Results” – For genetic testing or specific testing such as lumbar puncture (General labs are not needed.)
- “Radiology Reports” – MRI, CT scan, etc.
- “List of Active Medications”
- “Other” – add “All neurologically-related notes/reports”.
-> Delivery Instructions – Deliver to Rachel LaPaille-Harwood by email [email protected] or fax 904-953-7117
-> Mail To: Check either the “Same Address as Above” box to receive the records yourself or the “New Address Below” box to forward directly to Mayo and provide the following information: Dennis Dickson, MD, Mayo Clinic Jacksonville, Birdsall 310, 4500 San Pablo Road, Jacksonville, FL 32224-1865 (phone 904-953-2439, fax 904-953-7117). Note: Mailing is not a preferred option to send records to Mayo as things mailed by clinics get lost.
-> If the intended donor is not able to sign the form, the medical power-of-attorney should sign his/her name, date the form, and provide their relationship to the patient. Note: electronic signatures are not accepted at this time.
When you fax or email the completed authorization form, the VA requires a copy of the medical power-of-attorney document or advance directive as well.
Your request is processed within 10-14 days.
Using the contact information obtained in Step #3, we highly encourage a follow up call to the VA Release of Information department, Monday to Friday – 8:00am to 4:00pm, to ensure the request has been processed. Ask when the request will be completed. We suggest that you record the completion date and by what method it was sent to Mayo Clinic for tracking purposes.