Medical Records
Source: https://www.unitypoint.org/patients-and-visitors/medical-records
Archived: 2026-04-23 17:11
Medical Records
Medical Records
Your health record consists of information that we use to make decisions about you and includes your medical records. It is important that you keep information in your health record up-to-date. This page provides information on how you can exercise your rights regarding your health record, including obtaining a copy of your medical records, sending your records to a third party, making changes to your medical record, requesting a restriction on how we use or share your information and requesting a listing of where we have shared your health information. For more information on medical records, and how to make these requests, please see the
FAQs
Accessing Your Medical Records
Online Medical Records
Physical Copies of Your Records
Requesting Birth Certificates
Online Medical Records
MyUnityPoint Patient Portal
MyUnityPoint is a secure, online patient portal that allows you to access your medical records, communicate with your care team, pay bills and manage healthcare-related tasks. The MyUnityPoint patient portal may eliminate the need for separate paper medical record requests, saving you time and money. There is no fee for patients requesting and accessing their medical records through MyUnityPoint. You can download and print your records by selecting “Menu/My Record/Document Center.” If you do not already have one, you may create a MyUnityPoint account online.
Log In
Create Account
Billing Questions/Records
For billing questions or to obtain billing records, please contact our
Billing Department
.
Physical Copies of Your Records
Release of Medical Information
You can obtain a copy of your records or direct us to send your records to a third party. Requests may be made by phone, email or fax.
When requesting records, please be sure to include the following:
Patient-identifying information
Location/facility the records are needed from
Who should receive the records
What information should be sent (ex: lab, radiology report, billing, etc.)
Format in which you would like the information to be produced
Date of request
Signature (on written requests)
For your convenience, you may complete and submit the authorization request below to initiate your request.
Authorization/Request for Release of Health Information
Please mail the full completed authorization(s) to the appropriate UnityPoint Health facility listed in the
Release of Information
section below.
Medical Records
Delivery Options:
Electronically, either using the
MyUnityPoint
patient portal or via a secured/unsecured provided email address. (
Note
: If using an unsecured email address, there may be some level of risk that the protected health information (PHI) in the email could be read by a third party.)
Paper or CD/DVD mailed to the address specified in your request.
Arranged pick up. If you choose to pick up your medical records, please bring photo identification with you.
Illinois Only
Authorization Form for Relatives of a Deceased Person
(to request patient records of a deceased person)
For more information,
Contact Us
or read our
FAQs
.
Billing Questions/Records
For billing questions or to obtain billing records, please contact our
Billing Department
.
Requesting Birth Certificates
How to Request Birth Certificates
Birth certificates are not available through UnityPoint Health.
If you need a copy of your birth certificate, please contact your state's Vital Records department:
State
Address
Phone/Fax
Iowa Department of Health and Human Services
Vital Records
Birth Registration Program
Lucas State Office Building, 1st Floor
Des Moines, IA 50309-0075
Phone
: (515) 281-4944
Illinois Department of Public Health
Division of Vital Records
925 E. Ridgely Ave - 2737
Springfield, IL 62702
Fax
: (217) 523-2648
Wisconsin Vital Records Office
P.O. Box 309
Madison, WI 53701
Phone
: 877-855-2981
Contact Us
Please contact the Release of Information department for the facility you need records from.
Release of Information Contacts
Coverage Area
Included Locations
Contact Info
Phone
Fax
Email
Cedar Rapids, IA
Anamosa, IA
St. Luke's Hospital, Jones Regional Medical Center
UnityPoint Health - Cedar Rapids
Attn: Medical Records
1026 A. Ave. NE
Cedar Rapids, IA 52402
319-369-8227
319-368-5870
UPH_STLCR_ROI@unitypoint.org
Des Moines, IA and Grinnell, IA
Iowa Lutheran Hospital, Iowa Methodist Medical Center, Blank Children's Hospital, Methodist West Hospital, Grinnell Regional Medical Center
UnityPoint Health – Des Moines
Attn: Medical Records
1200 Pleasant Street
Des Moines, IA 50309
515-241-6306
515-241-4365
UPH_DSM_ROI@unitypoint.org
Dubuque, IA
Finley Hospital and select clinics
UnityPoint Health - Finley
Attn: Medical Records
350 N. Grandview Avenue
Dubuque, IA 52001
563-589-2441
563-589-2618
UPH_Finley_ROI@unitypoint.org
Former Grand River Medical Group Clinics
UnityPoint Clinic
Attn HIM Department
4025 Westmark Dr., Ste 200
Dubuque, IA 52002
563-557-3926
563-589-2618
UPH_Finley_ROI@unitypoint.org
Fort Dodge, IA
Trinity Regional Medical Center
UnityPoint Health - Ft. Dodge
Attn: Medical Records
802 Kenyon Rd.
Fort Dodge, IA 50501
515-574-6560
515-574-6963
UPH_TFD_ROI@unitypoint.org
Madison, WI
Meriter Hospital and clinics
UnityPoint Health – Meriter
202 S. Park Street
Madison, WI 53715
608-417-6406
608-417-6016
MSN_HIMROI@unitypoint.org
Marshalltown, IA
Marshalltown Hospital
UnityPoint Health - Marshalltown
Attn: Medical Records
55 UnityPoint Way
Marshalltown, IA 50158
641-328-7666
641-754-5150
UPH_AMH_ROI@unitypoint.org
Quad Cities, IA
Muscatine, IA
Trinity Rock Island, Trinity Moline, Trinity Bettendorf, Trinity Muscatine
UnityPoint Health - Quad Cities
Attn: Medical Records
2701 17th Street
Rock Island, IL 61201
563-742-3500
309-623-7053
UPH_TQC_ROI@unitypoint.org
Sioux City, IA
St. Luke's Hospital
UnityPoint Health - Sioux
City
Attn: Medical Records
2720 Stone Park Blvd.
Sioux City, IA 51104
712-279-3136
712-535-7179
UPH_STLSC_ROI@unitypoint.org
St. Luke's Hospital - Downtown
UnityPoint Health - Sioux
City
Attn: Medical Records
801 5th Street
Sioux City, IA 51101
712-279-2081
712-279-2207
trinitysiouxcityia@mrocorp.com
St. Luke's June E. Nylen Cancer Center
UnityPoint Health - St. Luke's June E. Nylen Cancer Center
230 Nebraska Street
Sioux City, IA 51101
712-252-3094
712-252-9428
UPH_STLSC_ROI@unitypoint.org
Waterloo, IA
Allen Hospital
UnityPoint Health - Allen Hospital
Attn: Medical Records
1825 Logan Avenue
Waterloo, IA 50703
319-235-3618
319-235-3191
UPH_AMH_ROI@unitypoint.org
UnityPoint at Home
888-584-6311
UPaHMedicalRecords@unitypoint.org
Specialty Pharmacy
888-584-6311
UPaHMedicalRecords@unitypoint.org
Medical Record FAQs
Who owns my UnityPoint Health medical record?
A: The information in your health record belongs to you. However, UnityPoint Health maintains the permanent record of the care provided to you.
Who has access to my records at UnityPoint Health?
A: Individuals participating in your care have access to your records to help them best provide for your health-care needs. After you receive treatment, other UnityPoint Health personnel performing the record-keeping duties also have access to your record. In either case, access is limited to the team members who need the information to perform their job.
Will you fax copies of my record to my home or office?
A: Yes, records can be faxed to a patient’s home or office. Patients should be aware that faxing to a shared or public fax machine may not be secured and protected. Records could be viewed or subject to access by third-party individuals or others who may have access to the fax machine. This could result in the sharing or further disclosure of your health information.
UnityPoint Clinic partners with a third-party vendor for release of information services. To request medical records from your clinic, submit an
Authorization/Request for Release of Health Information form
to your local UnityPoint Clinic location or contact the clinic directly.
I'm going to another healthcare provider and would like my records sent to this physician. What do I need to do?
A: Submit a completed “
Authorization/Request for Release of Health Information form
” form to have copies of your medical record mailed to that provider free of charge. Include the name and address of the healthcare provider. There’s no charge for copies of your medical record for continuity of care.
Are my records released outside UnityPoint Health?
Records are not released to a third party unless you've signed an authorization to allow this to occur. However, physicians involved with your care are allowed access to your record.
How to request a listing of where UnityPoint Health has disclosed your medical information
You have the right to receive an Accounting of Disclosures, which is a list of certain disclosures of your or your child’s health information made by UnityPoint Health or on your behalf over the past six years. The first list in any 12-month period will be provided free of charge; you may be charged a fee for each subsequent list you request within the same 12-month period.
Please note that our listing will not include the following disclosures:
To you,
To carry out treatment, payment, or health care operations,
Included as part of the patient directory, including directory information provided to members of the clergy or to other persons who ask for a patient by name,
“Incident to” an otherwise permitted use or disclosure,
Pursuant to an authorization that you completed,
To notify people identified to be involved in your care, including, but not limited to, family members, other relatives and close personal friends,
For disaster relief efforts,
To authorized federal officials for national security or intelligence purposes,
To a Correctional Institution or a Law Enforcement Official having Lawful Custody of an inmate,
As part of a Limited Data Set (limited information used for research, public health, or health care operations purposes).
If you would like to request an Accounting of Disclosures, please submit a request in writing using one of the methods described below:
Email
:
UPH_PrivacyOfficer@unitypoint.org
Mail
:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266
May I get a copy of a family member's medical record?
A: The patient or the patient's representative would need to consent to release of their medical records. However, if you have Power of Attorney (POA), or you're the executor of the patient's estate, you must submit an
Authorization/Request for Release of Health Information form
along with a copy of the legal document designating POA or executor rights.
I would like to know my blood type. Is this information in my medical record?
A: You must contact your physician's office for assistance. We don't keep private physician office medical records. However, if your physician specifically ordered a test in the hospital to determine your blood type (pregnancy, surgery, organ donation, or for a blood transfusion), your blood type may be in your hospital medical record and in this instance, we could release it.
How do I obtain the medical records of a deceased adult family member?
A: The administrator or executor of individual’s estate or the individual’s personal representative may authorize release of protected health information (PHI) pertaining to the decedent. The following documentation must be received to release the decedent’s records:
Death certificate
Name of Next of Kin/Executor of Estate
Authorization Relative Form
(Illinois Only)
Signed authorization (if directing to a third-party)
If there is no administrator, executor, or personal representative, the order of priority for information release will be:
A court-appointed guardian;
The individual’s spouse;
Adult children of the individual;
Either parent of the individual;
Adult siblings of the individual;
Other immediate or extended family members
Do you release any information verbally?
A: The only information HIS releases verbally is the patient's date of admission and/or date of discharge.
Can my spouse request and receive copies of my medical record?
A: No. Another person may not receive copies of your medical record without a consent form authorizing UnityPoint Health to release copies.
Should I keep a copy of my health record?
A: Keeping key documents from your health record is the best way to ensure your medical information is accessible when you need it. Although it’s not necessary to get copies every time you visit your doctor, you should consider getting copies of operative reports, discharge summaries and significant tests from any hospital visit.
How is my information safeguarded against unauthorized access?
A: At UnityPoint Health, we have a compliance program that includes policies implementing patient privacy and security requirements mandated under all applicable federal and state law. We provide training to our team members on the importance of complying with these policies and regularly conduct audits to confirm the effectiveness of our privacy and security compliance policies.
How to request a change (amendment) to your medical record
You may request that we amend or change certain health information that we keep in your or your child’s medical records if you believe that it is incorrect or incomplete.
Processing your amendment request may take up to 60 to 90 days. We are not required to make all requested amendments. For example, if the clinician who drafted a note in your medical record believes the note to be accurate, then we will not change it. If we deny your request, we will provide you with a written explanation of the reasons and your rights. More information is provided on the request form.
To request an amendment to your medical record, please complete a
Request for Amendment of Protected Health Information form
and submit it using one of the methods described below.
Email
:
UPH_PrivacyOfficers@unitypoint.org
Mail
:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266
How can I keep my medical record up-to-date?
It is important that you keep information in your health record up-to-date. Please tell us about the following:
A change to your address or phone number.
A change to your emergency contact.
Establishment of a guardianship by submitting the court order setting up the guardianship.
Finalization of an adoption by submitting an Adoption Decree/Decree of Adoption, Order on Petition for Adoption, or Finding and Order for Judgement and Decree of Adoption.
Any healthcare Power of Attorney documents.
If a family member who was a patient has passed away. Please include the patient’s full name, date of birth, date of death, relationship to patient and your phone number in case we have questions.
How do I request a restriction on how UnityPoint Health may disclose my medical information?
You have the right to request a restriction or limitation on how we use or disclose your or your child’s health information for treatment, payment, or health care operations or to people involved in your care or payment for your care.
We are not always required to agree to your request. However, if you pay out-of-pocket for your care, then then we will not share your health information with your insurer or health plan for payment or healthcare operations purposes.
Note
: If you pay for services out-of-pocket, you must make a separate restriction request at each UnityPoint Health location where you receive services.
To request a restriction, please complete a
Request to Restrict/Limit Use and Disclosure of Protected Health Information form
and submit it using one of the methods described below.
Email
:
UPH_PrivacyOfficers@unitypoint.org
Mail
:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266
How do I obtain a listing of where UnityPoint Health has disclosed my medical information?
You have the right to receive an Accounting of Disclosures, which is a list of certain disclosures of your or your child’s health information made by UnityPoint Health or on your behalf over the past six years. The first list in any 12-month period will be provided free of charge; you may be charged a fee for each subsequent list you request within the same 12-month period.
Please note that our listing will not include the following disclosures:
To you,
To carry out treatment, payment, or health care operations,
Included as part of the patient directory, including directory information provided to members of the clergy or to other persons who ask for a patient by name,
“Incident to” an otherwise permitted use or disclosure,
Pursuant to an authorization that you completed,
To notify people identified to be involved in your care, including, but not limited to, family members, other relatives and close personal friends,
For disaster relief efforts,
To authorized federal officials for national security or intelligence purposes,
To a Correctional Institution or a Law Enforcement Official having Lawful Custody of an inmate, or
As part of a Limited Data Set (limited information used for research, public health, or health care operations purposes).
If you would like to request an Accounting of Disclosures, please complete a
Request for Accounting of Disclosure of Protected Health Information form
and submit it using one of the methods described below.
Email
:
UPH_PrivacyOfficers@unitypoint.org
Mail
:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266
Medical Records
Your health record consists of information that we use to make decisions about you and includes your medical records. It is important that you keep information in your health record up-to-date. This page provides information on how you can exercise your rights regarding your health record, including obtaining a copy of your medical records, sending your records to a third party, making changes to your medical record, requesting a restriction on how we use or share your information and requesting a listing of where we have shared your health information. For more information on medical records, and how to make these requests, please see the
FAQs
Accessing Your Medical Records
Online Medical Records
Physical Copies of Your Records
Requesting Birth Certificates
Online Medical Records
MyUnityPoint Patient Portal
MyUnityPoint is a secure, online patient portal that allows you to access your medical records, communicate with your care team, pay bills and manage healthcare-related tasks. The MyUnityPoint patient portal may eliminate the need for separate paper medical record requests, saving you time and money. There is no fee for patients requesting and accessing their medical records through MyUnityPoint. You can download and print your records by selecting “Menu/My Record/Document Center.” If you do not already have one, you may create a MyUnityPoint account online.
Log In
Create Account
Billing Questions/Records
For billing questions or to obtain billing records, please contact our
Billing Department
.
Physical Copies of Your Records
Release of Medical Information
You can obtain a copy of your records or direct us to send your records to a third party. Requests may be made by phone, email or fax.
When requesting records, please be sure to include the following:
Patient-identifying information
Location/facility the records are needed from
Who should receive the records
What information should be sent (ex: lab, radiology report, billing, etc.)
Format in which you would like the information to be produced
Date of request
Signature (on written requests)
For your convenience, you may complete and submit the authorization request below to initiate your request.
Authorization/Request for Release of Health Information
Please mail the full completed authorization(s) to the appropriate UnityPoint Health facility listed in the
Release of Information
section below.
Medical Records
Delivery Options:
Electronically, either using the
MyUnityPoint
patient portal or via a secured/unsecured provided email address. (
Note
: If using an unsecured email address, there may be some level of risk that the protected health information (PHI) in the email could be read by a third party.)
Paper or CD/DVD mailed to the address specified in your request.
Arranged pick up. If you choose to pick up your medical records, please bring photo identification with you.
Illinois Only
Authorization Form for Relatives of a Deceased Person
(to request patient records of a deceased person)
For more information,
Contact Us
or read our
FAQs
.
Billing Questions/Records
For billing questions or to obtain billing records, please contact our
Billing Department
.
Requesting Birth Certificates
How to Request Birth Certificates
Birth certificates are not available through UnityPoint Health.
If you need a copy of your birth certificate, please contact your state's Vital Records department:
State
Address
Phone/Fax
Iowa Department of Health and Human Services
Vital Records
Birth Registration Program
Lucas State Office Building, 1st Floor
Des Moines, IA 50309-0075
Phone
: (515) 281-4944
Illinois Department of Public Health
Division of Vital Records
925 E. Ridgely Ave - 2737
Springfield, IL 62702
Fax
: (217) 523-2648
Wisconsin Vital Records Office
P.O. Box 309
Madison, WI 53701
Phone
: 877-855-2981
Contact Us
Please contact the Release of Information department for the facility you need records from.
Release of Information Contacts
Coverage Area
Included Locations
Contact Info
Phone
Fax
Cedar Rapids, IA
Anamosa, IA
St. Luke's Hospital, Jones Regional Medical Center
UnityPoint Health - Cedar Rapids
Attn: Medical Records
1026 A. Ave. NE
Cedar Rapids, IA 52402
319-369-8227
319-368-5870
UPH_STLCR_ROI@unitypoint.org
Des Moines, IA and Grinnell, IA
Iowa Lutheran Hospital, Iowa Methodist Medical Center, Blank Children's Hospital, Methodist West Hospital, Grinnell Regional Medical Center
UnityPoint Health – Des Moines
Attn: Medical Records
1200 Pleasant Street
Des Moines, IA 50309
515-241-6306
515-241-4365
UPH_DSM_ROI@unitypoint.org
Dubuque, IA
Finley Hospital and select clinics
UnityPoint Health - Finley
Attn: Medical Records
350 N. Grandview Avenue
Dubuque, IA 52001
563-589-2441
563-589-2618
UPH_Finley_ROI@unitypoint.org
Former Grand River Medical Group Clinics
UnityPoint Clinic
Attn HIM Department
4025 Westmark Dr., Ste 200
Dubuque, IA 52002
563-557-3926
563-589-2618
UPH_Finley_ROI@unitypoint.org
Fort Dodge, IA
Trinity Regional Medical Center
UnityPoint Health - Ft. Dodge
Attn: Medical Records
802 Kenyon Rd.
Fort Dodge, IA 50501
515-574-6560
515-574-6963
UPH_TFD_ROI@unitypoint.org
Madison, WI
Meriter Hospital and clinics
UnityPoint Health – Meriter
202 S. Park Street
Madison, WI 53715
608-417-6406
608-417-6016
MSN_HIMROI@unitypoint.org
Marshalltown, IA
Marshalltown Hospital
UnityPoint Health - Marshalltown
Attn: Medical Records
55 UnityPoint Way
Marshalltown, IA 50158
641-328-7666
641-754-5150
UPH_AMH_ROI@unitypoint.org
Quad Cities, IA
Muscatine, IA
Trinity Rock Island, Trinity Moline, Trinity Bettendorf, Trinity Muscatine
UnityPoint Health - Quad Cities
Attn: Medical Records
2701 17th Street
Rock Island, IL 61201
563-742-3500
309-623-7053
UPH_TQC_ROI@unitypoint.org
Sioux City, IA
St. Luke's Hospital
UnityPoint Health - Sioux
City
Attn: Medical Records
2720 Stone Park Blvd.
Sioux City, IA 51104
712-279-3136
712-535-7179
UPH_STLSC_ROI@unitypoint.org
St. Luke's Hospital - Downtown
UnityPoint Health - Sioux
City
Attn: Medical Records
801 5th Street
Sioux City, IA 51101
712-279-2081
712-279-2207
trinitysiouxcityia@mrocorp.com
St. Luke's June E. Nylen Cancer Center
UnityPoint Health - St. Luke's June E. Nylen Cancer Center
230 Nebraska Street
Sioux City, IA 51101
712-252-3094
712-252-9428
UPH_STLSC_ROI@unitypoint.org
Waterloo, IA
Allen Hospital
UnityPoint Health - Allen Hospital
Attn: Medical Records
1825 Logan Avenue
Waterloo, IA 50703
319-235-3618
319-235-3191
UPH_AMH_ROI@unitypoint.org
UnityPoint at Home
888-584-6311
UPaHMedicalRecords@unitypoint.org
Specialty Pharmacy
888-584-6311
UPaHMedicalRecords@unitypoint.org
Medical Record FAQs
Who owns my UnityPoint Health medical record?
A: The information in your health record belongs to you. However, UnityPoint Health maintains the permanent record of the care provided to you.
Who has access to my records at UnityPoint Health?
A: Individuals participating in your care have access to your records to help them best provide for your health-care needs. After you receive treatment, other UnityPoint Health personnel performing the record-keeping duties also have access to your record. In either case, access is limited to the team members who need the information to perform their job.
Will you fax copies of my record to my home or office?
A: Yes, records can be faxed to a patient’s home or office. Patients should be aware that faxing to a shared or public fax machine may not be secured and protected. Records could be viewed or subject to access by third-party individuals or others who may have access to the fax machine. This could result in the sharing or further disclosure of your health information.
UnityPoint Clinic partners with a third-party vendor for release of information services. To request medical records from your clinic, submit an
Authorization/Request for Release of Health Information form
to your local UnityPoint Clinic location or contact the clinic directly.
I'm going to another healthcare provider and would like my records sent to this physician. What do I need to do?
A: Submit a completed “
Authorization/Request for Release of Health Information form
” form to have copies of your medical record mailed to that provider free of charge. Include the name and address of the healthcare provider. There’s no charge for copies of your medical record for continuity of care.
Are my records released outside UnityPoint Health?
Records are not released to a third party unless you've signed an authorization to allow this to occur. However, physicians involved with your care are allowed access to your record.
How to request a listing of where UnityPoint Health has disclosed your medical information
You have the right to receive an Accounting of Disclosures, which is a list of certain disclosures of your or your child’s health information made by UnityPoint Health or on your behalf over the past six years. The first list in any 12-month period will be provided free of charge; you may be charged a fee for each subsequent list you request within the same 12-month period.
Please note that our listing will not include the following disclosures:
To you,
To carry out treatment, payment, or health care operations,
Included as part of the patient directory, including directory information provided to members of the clergy or to other persons who ask for a patient by name,
“Incident to” an otherwise permitted use or disclosure,
Pursuant to an authorization that you completed,
To notify people identified to be involved in your care, including, but not limited to, family members, other relatives and close personal friends,
For disaster relief efforts,
To authorized federal officials for national security or intelligence purposes,
To a Correctional Institution or a Law Enforcement Official having Lawful Custody of an inmate,
As part of a Limited Data Set (limited information used for research, public health, or health care operations purposes).
If you would like to request an Accounting of Disclosures, please submit a request in writing using one of the methods described below:
:
UPH_PrivacyOfficer@unitypoint.org
:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266
May I get a copy of a family member's medical record?
A: The patient or the patient's representative would need to consent to release of their medical records. However, if you have Power of Attorney (POA), or you're the executor of the patient's estate, you must submit an
Authorization/Request for Release of Health Information form
along with a copy of the legal document designating POA or executor rights.
I would like to know my blood type. Is this information in my medical record?
A: You must contact your physician's office for assistance. We don't keep private physician office medical records. However, if your physician specifically ordered a test in the hospital to determine your blood type (pregnancy, surgery, organ donation, or for a blood transfusion), your blood type may be in your hospital medical record and in this instance, we could release it.
How do I obtain the medical records of a deceased adult family member?
A: The administrator or executor of individual’s estate or the individual’s personal representative may authorize release of protected health information (PHI) pertaining to the decedent. The following documentation must be received to release the decedent’s records:
Death certificate
Name of Next of Kin/Executor of Estate
Authorization Relative Form
(Illinois Only)
Signed authorization (if directing to a third-party)
If there is no administrator, executor, or personal representative, the order of priority for information release will be:
A court-appointed guardian;
The individual’s spouse;
Adult children of the individual;
Either parent of the individual;
Adult siblings of the individual;
Other immediate or extended family members
Do you release any information verbally?
A: The only information HIS releases verbally is the patient's date of admission and/or date of discharge.
Can my spouse request and receive copies of my medical record?
A: No. Another person may not receive copies of your medical record without a consent form authorizing UnityPoint Health to release copies.
Should I keep a copy of my health record?
A: Keeping key documents from your health record is the best way to ensure your medical information is accessible when you need it. Although it’s not necessary to get copies every time you visit your doctor, you should consider getting copies of operative reports, discharge summaries and significant tests from any hospital visit.
How is my information safeguarded against unauthorized access?
A: At UnityPoint Health, we have a compliance program that includes policies implementing patient privacy and security requirements mandated under all applicable federal and state law. We provide training to our team members on the importance of complying with these policies and regularly conduct audits to confirm the effectiveness of our privacy and security compliance policies.
How to request a change (amendment) to your medical record
You may request that we amend or change certain health information that we keep in your or your child’s medical records if you believe that it is incorrect or incomplete.
Processing your amendment request may take up to 60 to 90 days. We are not required to make all requested amendments. For example, if the clinician who drafted a note in your medical record believes the note to be accurate, then we will not change it. If we deny your request, we will provide you with a written explanation of the reasons and your rights. More information is provided on the request form.
To request an amendment to your medical record, please complete a
Request for Amendment of Protected Health Information form
and submit it using one of the methods described below.
:
UPH_PrivacyOfficers@unitypoint.org
:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266
How can I keep my medical record up-to-date?
It is important that you keep information in your health record up-to-date. Please tell us about the following:
A change to your address or phone number.
A change to your emergency contact.
Establishment of a guardianship by submitting the court order setting up the guardianship.
Finalization of an adoption by submitting an Adoption Decree/Decree of Adoption, Order on Petition for Adoption, or Finding and Order for Judgement and Decree of Adoption.
Any healthcare Power of Attorney documents.
If a family member who was a patient has passed away. Please include the patient’s full name, date of birth, date of death, relationship to patient and your phone number in case we have questions.
How do I request a restriction on how UnityPoint Health may disclose my medical information?
You have the right to request a restriction or limitation on how we use or disclose your or your child’s health information for treatment, payment, or health care operations or to people involved in your care or payment for your care.
We are not always required to agree to your request. However, if you pay out-of-pocket for your care, then then we will not share your health information with your insurer or health plan for payment or healthcare operations purposes.
Note
: If you pay for services out-of-pocket, you must make a separate restriction request at each UnityPoint Health location where you receive services.
To request a restriction, please complete a
Request to Restrict/Limit Use and Disclosure of Protected Health Information form
and submit it using one of the methods described below.
:
UPH_PrivacyOfficers@unitypoint.org
:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266
How do I obtain a listing of where UnityPoint Health has disclosed my medical information?
You have the right to receive an Accounting of Disclosures, which is a list of certain disclosures of your or your child’s health information made by UnityPoint Health or on your behalf over the past six years. The first list in any 12-month period will be provided free of charge; you may be charged a fee for each subsequent list you request within the same 12-month period.
Please note that our listing will not include the following disclosures:
To you,
To carry out treatment, payment, or health care operations,
Included as part of the patient directory, including directory information provided to members of the clergy or to other persons who ask for a patient by name,
“Incident to” an otherwise permitted use or disclosure,
Pursuant to an authorization that you completed,
To notify people identified to be involved in your care, including, but not limited to, family members, other relatives and close personal friends,
For disaster relief efforts,
To authorized federal officials for national security or intelligence purposes,
To a Correctional Institution or a Law Enforcement Official having Lawful Custody of an inmate, or
As part of a Limited Data Set (limited information used for research, public health, or health care operations purposes).
If you would like to request an Accounting of Disclosures, please complete a
Request for Accounting of Disclosure of Protected Health Information form
and submit it using one of the methods described below.
:
UPH_PrivacyOfficers@unitypoint.org
:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266