Release of Medical Records

Community Health Network (CHN) is dedicated to maintaining a high level of privacy and confidentiality with all patient records. CHN keeps all health information private and secure in accordance with federal and state regulations.


CHN respects the health information rights of its patients (and their applicable guardians/legal representatives, if any), including the right to access their protected health information.

Written Authorization

Requests for the release of medical, dental, behavioral health and billing records (protected health information) must be submitted in writing. Authorizations must be dated and signed by the patient or the patient’s legally authorized representative. In the case of a minor, a parent or legal guardian must sign the authorization. 


CHN works to respond to all requests in a timely manner. Patients can expect to receive the requested records within 5 – 7 business days of the date CHN receives the medical records request.

CHN HAS AUTHORIZATION FORMS AVAILABLE TO DOWNLOAD


To release information to the patient and other healthcare organizations – CLICK HERE

To retrieve and release records to Community Health Network – CLICK HERE
 

Submitting an Authorization
Completed authorization forms may be submitted to CHN by fax, mail or in person

Medical Records Fax #: 281-220-6442

 (This fax number applies to ALL requests)

Mailing Address:

Stephen F. Austin Community Health Network

Medical Records Dept.

1111 W. Adoue Street

Alvin, TX. 77511

.
 

For healthcare facilities requesting records, if the patient is in the office or has an upcoming appointment please indicate on the request and fax to 281-220-6442. 

To assure you receive the requested health records in a timely manner, it is extremely important that the release form be completed accurately and thoroughly. A lack of information could result in a delay in processing your request.


Per 45 CFR § 164.524, reasonable fees may apply to the request of medical records.


For further information regarding the release of medical records, please contact CHN’s Call Center at (281)-824-1480.