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How to Request a Copy of Your Medical Records
To request a copy of your NIH Clinical Center (CC) medical records and/or CD images, you will need to complete our Authorization for Release of Information form (Para Español Autorización para la Divulgación de Información Médica).
The NIH CC also offers secure, electronic access to your radiology images through Nuance PowerShare. This allows you to view your radiology images, share them with providers outside NIH, and receive them electronically instead of on a CD. Complete the Authorization for Electronic Image Access form to get started. Review the Nuance PowerShare quick reference resource or full user guide to learn more. PowerShare is used for imaging only. For electronic access to medical information including lab test results, radiology results and more, please use the FollowMyHealth Patient Portal.
If you have any questions about how to complete the forms above or the release process, please call us at 888-790-2133.
These forms can be mailed, faxed, or submitted electronically using the following instructions:
The Health Information Management Division (HIMD) uses an NIH approved secure file sharing service, BOX, to allow for electronic submission of completed Authorization for Release of Information Forms.
NOTE: Authorization forms must include a manual/handwritten signature using paper and pen or a manual/handwritten signature on an electronic device using a mouse, stylus, finger, etc. Typed signatures or digital signatures enabled by certificates will not be accepted.
- Written Directions for How To Complete the Authorization for Release of Information
- Written Directions for How To Electronically Sign and Submit This Form
If the patient is 18 years of age or older, the patient is the only person who is permitted to sign this form. If the patient is under the age of 18, the parent or guardian must sign this form. Review the Turning 18 at the NIH Clinical Center resource for more information (Para Español Eres un participante o paciente en el Centro Clínico de los NIH y cumples 18 años).
There are situations in which this general rule does not apply. For consultation regarding who is authorized to sign this form, contact the Health Information Management Division at 1-888-790-2133.
- Drag and drop your file into the box above or select browse your device to choose your file.
- In the File Description text box, type in your full legal name, date of birth, and any other information you would like to convey with the form (Optional).
- Enter your e-mail address (Required).
- Select the Upload button once.
- You will receive the following message on-screen after the upload has been successful:
Success. Your file has been uploaded, and the owner has been notified.
BOX is a secure commercial site approved by NIH which provides an easy and fast method for sending and receiving large files. For additional details, please contact the Health Information Management Division at 1-888-790-2133 or review the BOX website.
Introduction
The NIH Clinical Center (CC) is committed to protecting the privacy of CC patient information contained in NIH information systems. The CC Health Information Management Department (HIMD) uses BOX, an NIH approved third party secure file sharing service, to send/ receive forms to registered CC patients. The NIH agency's Privacy Policy, but does not apply. In this instance, the BOX Privacy Policy applies and is located at https://www.box.com/legal/privacypolicy.
Purposes and Use of Information We Collect from You
This Privacy Notice explains the collection and use of Personally Identifiable Information (PII) about you through the CC HIMD Website. The BOX application presents a form and asks for your name, your e-mail and an open text message. The information collected reflects the minimum necessary to accomplish the purpose of uploading the signed Authorization for the Release of Medical Information form, and other patient completed authorization forms (patient portal consents, etc.) to the CC Health Information Management Department.
By using the third-party BOX Website to send signed document(s) to the NIH CC Health Information Management Department, you may be providing nongovernmental third-parties with access to PII and/or sensitive information. Please note that by voluntarily providing your information and uploading documents into this site, you are accepting the practices described in this Privacy Notice and consent to the collection, storage, and use of personal information about you as described in this Notice. Use of this service is optional. If you do not wish to use this service, but still wish to send the signed document, you may mail the document to CC Health Information Management Department, 10 Center Drive, Room B1L400, MSC 1192 Bethesda, MD 20892 or fax to 301-480-9982.
Security of Information
At all times, security maintenance and administration is an important part of website operations and maintenance. BOX maintains approved physical, electronic and procedural safeguards to comply with federally approved standards to guard your nonpublic personal information. The system uses appropriate administrative, technical and physical controls for protection of information contained therein and is protected by multiple firewalls, vulnerability scanning, and advanced encryption technology. Access to your information requires entry of a personalized username and password by CC HIMD staff. In non-routine circumstances, system administrators at BOX may have incidental exposure to your information during unexpected events such as data recovery.
Contact Us
If you have any questions or concerns regarding this Privacy Notice, please call the CC Health Information Management Department (HIMD) at 1-888-790-2133.