My Health Care Information

Personal health information includes information such as your name, date of birth, address, health history and records of your visits to the hospital and the care that you received during those visits. Your medical record contains your personal health information. Occasionally, we collect personal health information about you from other health information organizations or providers if we have obtained your consent, or as the law permits.

The information about you contained in your medical record belongs to you. You have a right to access the information in your medical chart under the law, with some limited exceptions. In order to do so, please contact the Release of Information Department at Kingston Health Sciences Centre (KHSC) where they handle all requests for both hospital sites.

Release of Information
Kingston Health Sciences Centre
76 Stuart St, Kingston ON K7L 2V7
Phone: 613-549-6666 extension 4949
Fax:  613-542-8071
Email: KHSCroiRequest@KingstonHSC.ca

NOTE: Diagnostic reports and medical records will only be released via mail or in person as arranged with Health Information  Services (613-549-6666 ext. 4949)

Yes. If you would like a copy of your medical record, please complete the form below and mail or fax it to the KHSC Release of Information Department or hand it in to the Medical Records Department on Kidd/Davis 1.

• Request for Access to the Personal Health Record  

Health Information Services will provide a copy of your diagnostic tests that have been completed at KHSC within the last 30 days and only those that are identified below. Some test results may not be  stored in our Patient Care System (PCS) and those results will have to be released by the department directly (e.g. Renal care, Cancer Centre).  To get a copy you must complete the form linked below.

You may submit the completed form to KHSCroiRequest@KingstonHSC.ca or Fax:  613-542-8071 or direction to Health Information Services. Patients seeking diagnostic test results from the Cancer Centre and/or the Renal Care Program should submit this form directly to their clinician.

Examples of Testing (NOTE: must have occurred within last 30 days)

1. Audiogram
2. Blood work (lab)
3. Echocardiogram (Echo)
4. Electrocardiogram (ECG)
5. Electroencephalogram (EEG)
6. Electromyogram, Electro diagnostic Laboratory (EMG)
7. Gastroenterology (GI) tests
8. Holter Reports (first 2 pages)
9. Imaging /X-RAYS (CT, MRI, Doppler)
10. Neuro Physiological Testing (ENG)
11. Pathology
12. Pulmonary Function Tests (PFT)
13. Stress Tests (Tread Mill)
14. Vestibular Function Lab (VNG)

• Request for receipt of Diagnostic Testing Reports

The law allows the hospital to charge a fee to recover costs. When you submit the form you will be informed if a fee applies. 

• Release of Information fee schedule 

If you would like some or all of your medical record to be sent outside the hospital to your insurance company, lawyer or another hospital, please complete the form below:

• Authorization to Release your Personal Health Information 

Only those who need it to provide you with health care. Your health care team needs access in order to plan and deliver your health care. This may include sharing your health information with:

• Other approved health information organizations or providers (e.g. Community Care Access Centre, family physicians, community mental health)
• eHealth Ontario provincial electronic health record and other regional health information repositories (e.g. South East Health Integration Information Portal (SHIIP))
• Other allied health care professionals who will provide your follow-up care

Yes. We may use or share your personal health information to:

• Perform activities to improve and maintain the quality of the care that we deliver to you;
• Conduct risk management activities;
• Teach health care professionals (we use de-identified information where possible);
• Plan, administer and manage our internal operations;
• Obtain payment for delivery of your health care (e.g. from OHIP, WSIB or others);
• Fund-raise to improve our health care services and programs (information limited to name and address);
• To conduct research;
• Comply with legal and regulatory requirements.

Yes. At any time you may withdraw your consent to share your personal health information for research, fundraising or patient satisfaction surveys, etc. To do so, please ask us in writing using the form below:

• Withdrawal of Consent Form 

Yes. If you believe that factual information in your medical record is incorrect, you have the right to ask to have it corrected. 

• Request for Correction to Personal Health Record 

Your first step is to complete the form below. An interview/discussion will be arranged with the Privacy Officer/delegate and you once the form has been completed. 

• Request to Lock Personal Health Information 
• Request to revoke consent to lock Personal Health Information

There are laws that require us to retain records for periods of time; generally adult patient records are kept for 15 years following the last visit or death and children’s records are kept for 15 years past the child’s 18th birthday. *If you participated in approved health care research, your personal health information could be retained for 15 years following the completion of the research.

If you have reason to believe your privacy has been breached or accessed by a person(s) unauthorized to do so without your consent, please contact the Privacy Office at:

Privacy and Freedom of Information Office
Kingston Health Sciences Centre
76 Stuart Street
Kingston, ON K7L 2V7
Phone: (613) 549-6666 or 1-800-567-5722 Ext. 2567
Fax: (613) 548-2445
Email: Privacy@KingstonHSC.ca

You have the right to complain to the Information and Privacy Commissioner/Ontario if we have been unable to resolve your concern.

Information and Privacy Commissioner/Ontario
2 Bloor St. East, Suite 1400
Toronto, ON, M4W 1A8
Phone: 416-326-3333 or 1-800-387-0073
Fax: 416-325-9195
Website: www.ipc.on.ca