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Health Information Services

Health Information Services oversees the collection, storage, retention, access and disclosure of the HGMH health records. 

Our Mission

  • To maintain confidential, accurate and secure health record systems.
  • To protect the privacy of patients by ensuring that access to their personal health information is appropriate and in accordance with hospital policies and legislation.
  • To maintain a high quality service by providing our clients with the right information, to the right person, at the right time, in the right place in a courteous, respectful and timely manner.

Release of Information

General information requests will be handled by telephone but health information cannot be released over the telephone.   For your protection, health information will not be released to third parties without your written authorization or consent.  All requests for release of information from your health record must be made in writing and an original consent is required authorizing us to release information.  The consent must be signed, dated and witnessed.  Also indicate your date of birth, the specific information you wish released and to whom the information is being released.   The request may be sent by mail or you may come to the department to complete an authorization. 

All requests must be accompanied by a completed Authorization For Release of Information Form.

Blood Type

The patient must contact the family physician for this information.  Health Information Services will not give blood type information over the telephone.

Fee for Release of Information

There is no release of information fee if the health information is being released to your circle of care providers. 

There is an administrative fee for non-medical requests,  e.g. your lawyer may receive health information with your consent.  

Release of Information Fee Schedule:

Category Fee
Canadian College of Physicians/Nurses $50.00
Insurance Companies  $200.00 plus $0.75/copy after 20 copies
Lawyers  $200.00 after 20 copies
Legal Aid  $50
Letter of Confirmation for Employer, etc. $10.00
Medical Professionals (when they are involved in care) No charge
Ontario WSIB  $48.15
Other Provincial WSIB  $150.00 plus $0.75/copy
Patient Access  $30.00
Patient Access (H.I.S. Manager to sit with patient to review) $25.00
Pension Compensation Board  $125.00
Proof of Death in Hospital for Family No charge
Proof of Birth  $30.00
Time of Birth  $100.00 

Contact Us

By phone:  613.525.2222 ext 4137

By fax:  613.525.2147

By mail: 

Health Information Services
Hôpital Glengarry Memorial Hospital
20260 County Road 43
Alexandria, ON      K0C 1A0

Hours of Operation:    8:00 AM - 4:00 PM  Monday to Friday

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