AOAÌåÓýƽ̨

Most AOAÌåÓýƽ̨ patient medical records are available at no cost through MyChart. If you don't have a MyChart account, will help you sign up. Call 855-255-2300 for MyChart assistance.

To request medical records through MyChart:

1. .
2. Click Your Menu in the top left corner
3. Look for the My Records section and click Request My Records
4. Follow the instructions to complete your request.

Your medical records will be delivered to your MyChart account within seven to ten business days. Records that require a provider’s approval for release may take longer.

Fees for paper copies:

There may be a “reasonable cost-based fee� for copying protected health information in accordance with the State of Maine or New Hampshire Statutes. The exact fee amount will not be determined until the request has been fulfilled, at which time an invoice will be sent. In some cases, fees may be required prior to releasing the records requested. We accept payment by check, exact cash or credit/debit card.

There is no charge for:

• Records delivered electronically through MyChart
• Paper records that are sent directly to another health care provider

To request medical records by mail, fax or email:

• Download and print the AOAÌåÓýƽ̨ .
  • if you need help.
  • Call 207-662-2211 if you would like us to fax or mail the form to you.
• Complete, sign and date the form.
• Include a legible photocopy of a valid photo identification (your driver’s license, military ID or state issued ID).
• Submit all completed and signed documents to AOAÌåÓýƽ̨ via MyChart, email, mail or fax:
   
  • MyChart:
  • Email:RecordRequests@AOAÌåÓýƽ̨.org
  • Mail: Health Information Management Department, 301C US Route One, Scarborough, ME 04074.
  • Fax: 207-761-3092

Please allow us time to process your request. Requests are usually completed within 7-10 days but may take up to 30 days. We will contact you if your request will be delayed or if we cannot fulfill your request.

Please note:

• Your medical records will include protected health information related to care at all AOAÌåÓýƽ̨ locations.
• You must complete ALL FIELDS on our per . If any information is missing from the form, or if the form is not signed and dated, your request may be delayed or returned.
• Authorization requests signed by your legal representative must also include a copy of one of the following documents:
  • Legal guardianship papers
  • Advance directive or health care power of attorney, for patients unable to make health care decisions
  • Designation of a personal representative, which allows the representative to act on the patient's behalf with regard to personal health information

Fees for paper copies:

There may be a “reasonable cost-based fee� for copying protected health information in accordance with the State of Maine or New Hampshire Statutes. The exact fee amount will not be determined until the request has been fulfilled, at which time an invoice will be sent. In some cases, fees may be required prior to releasing the records requested. We accept payment by check, exact cash or credit/debit card.

There is no charge for:

• Records delivered electronically through MyChart
• Paper records that are sent directly to another health care provider

For immediate continuity-of-care requests, you or your health care provider may submit a request to have your health information sent directly to another health care provider's office.

If your health care provider is submitting the request, they should:
 

• Create a written request on their business letterhead
• Write "STAT" at the top of the request
• Note the patient's name, date of birth, date of service and health information being requested
• Fax the written request to 207-761-3092

If you are submitting the request, please:

• Complete our
  • if you need help.
  • Call 207-662-2211 if you would like us to fax or mail the form to you.
• Complete, sign and date the form.
  • Enter the health care provider's office and contact information in the Release Information To section
• Include a legible photocopy of a valid photo identification (your driver’s license, military ID or state issued ID).
• Write "STAT" at the top of the completed form
• Fax the completed form and photocopy to 207-761-3092

Note: Please mail all subpoena-related documents, non-patient directed requests, and/or audit requests to:

Health Information Management Department
301C US Route One
Scarborough, ME 04074

To request the medical records of a deceased patient:

• Download and print the AOAÌåÓýƽ̨ . View .
• Complete, sign and date the form.
• Include a copy of the patient's death certificate or evidence of probate court appointment as Executor of Estate
  • Instead of Executor of Estate appointment evidence, a completed form may be submitted along with the and a copy of the patient's death certificate.
• Submit all completed and signed documents to AOAÌåÓýƽ̨ via MyChart, email, mail or fax:
   
  • MyChart:
  • Email:RecordRequests@AOAÌåÓýƽ̨.org
  • Mail: Health Information Management Department, 301C US Route One, Scarborough, ME 04074.
  • Fax: 207-761-3092

Records can be released to anyone whom the patient authorizes (in writing) to receive them. If an expiration date is not noted, the authorization is valid for one year.

All imaging results (computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, etc.) are available for release to patients*, providers or medical offices via .

• The easiest and fastest way for providers and medical offices to request radiology records and images is directly through .
• AOAÌåÓýƽ̨ has a single  account that covers all AOAÌåÓýƽ̨ locations.
• Radiology records and image requests may also be faxed to 207-662-6044 or emailed to [email protected]

* Patients who would like to receive their imaging electronically through PowerShare should submit their request through , or complete an and email or fax it to the Film Library. Be sure to include your email address.

Please call 207-662-2328 for assistance with urgent requests.

AOAÌåÓýƽ̨ does not maintain birth certificates. Birth certificates can be obtained from the City or Town Clerk’s office in your area or, via the Maine or New Hampshire Vital Records offices.

Maine

• : 888-664-9491
• 207-338-3370
• : 207-284-9307
• : 207-725-6658
   
• : 207-563-5168
• : 207-778-6539
• : 207-743-6651
• 207-874-8610
• 207-236-9648

New Hampshire

• 877-878-8007
• 603-447-3811

To request a medical record amendment:
 

• Complete our Request for Amendment of Protected Health Information form.
• Submit all completed and signed documents to AOAÌåÓýƽ̨ via MyChart, email, mail or fax:
   
  • MyChart:
  • Email:RecordRequests@AOAÌåÓýƽ̨.org
  • Mail: Health Information Management Department, 301C US Route One, Scarborough, ME 04074.
  • Fax: 207-761-3092

Please see our  for more information on the amendment process.

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