Medical Records Requests
Thank you for reaching out to request your records. Kindly complete the form below and press send. Please note that records can take up to 30 days by law to process but we make every effort to process these quickly.
All requests need to come on the attached form. Please note if a patient is over the age of 18 and has not designated a parent/guardian on a current HIPAA (signed within one year of turning 18), the patient themselves need to request the records. If a patient is requesting another person to pick up their records, this must be included on their request. If a patient wishes to have their records mailed, payment must be made by check once a total is sent to the patient by email prior to records being mailed. Please note all requests need to be paid for by cash (exact change) or check. Credit cards cannot be accepted for any medical records requests. All records must be picked up in the Cedar Knolls office located at 218 Ridgedale Ave. STE 101, Cedar Knolls, NJ 07927. All records must be paid for by cash (exact change) or check at the time of pick-up.
Frequently Asked Questions
What are the fees for medical records?
Fees for records are as follows and can only be paid by cash or check. Unfortunately, we cannot accept credit card payments.
- $3 per x-ray print (images cannot be emailed or faxed)
- $20 x-ray CD (contains all images taken in the office back to 2012)
- Office notes: $10 for up to the first 10 pages and $1 per page thereafter
- FMLA forms and sports forms: $10
Once the records are requested you will receive a confirmation email. Again, records can take up to 30 days but are usually processed quicker. All office notes need to be signed off on by the appropriate doctors before they can be released.
Legal requests and letters of protections
All requests for records for legal matters must come through the attorney’s office. *Our office under no circumstances accepts Letters of Protection for holds on payment of services.
How do I obtain my medical record?
You can request medical records in several ways:
- Complete the online patient authorization for release of information.
- Request your records through the patient portal
- Fax a detailed written request to 973-538-9478 that includes the patient’s name/DOB and specifically what you are requesting. If a patient is 18 years of age or older the request must come from the patient not the guardian.
- Send an email request to stephanie.ruzicka@consensushealth.com
Is there a cost for copies of my medical records?
- Medical records sent directly to a physician’s office or other health care facility are always free if we are referring you to another facility or doctor
- Medical records released to a patient’s portal in the form of care summaries are free and can be obtained directly from the Athena patient portal
- Medical records for military requests are no charge
- X-ray discs for patients referred to SCHROTH therapy are no charge
- All other medical records follow the fee schedule listed above under fees.
Both HIPAA and state rules determine the applicable fee for medical records. If there is a fee to process your request, the invoice will be emailed to the address provided on your form. Payments can be made by cash or check at pick up. If mailing a check, please make checks payable to: The Pediatric Orthopedic Center and send to:
Attn: Medical Records, The Pediatric Orthopedic Center, 218 Ridgedale Ave, STE 101, Cedar Knolls, NJ 07927.
When can I expect to receive a copy of medical records?
The Pediatric Orthopedic Center will make every effort to prepare your medical records in a timely manner, but by law, we are allowed up to 30 days. Please allow for this processing time when making your request.
Can someone else pick-up my medical records?
Yes, as long as you give the name of the person you are giving permission to pick up on your original written request. The designee must present a valid driver’s license, passport or county identification at the time of pick up.
Who is authorized to sign a patient's authorization for release?
- Yourself (not your spouse unless otherwise designated on your request)
Proof of ID will be required - A parent or legal-guardian if the patient is under the age of 18 years of age (Must provide legal documents)
- Power of Attorney if patient is unable to sign (must have documentation)
- Executor/representative of estate for a deceased patient with a copy of the short form (death certificate presented)
- A minor may sign their own authorization if they are:
- Emancipated
- Pregnant
- Being treated for venereal disease, sexual assault, alcohol or drug use/abuse
- Age 14 or older and is admitted to a psychiatric facility, children’s crisis intervention service or special psychiatric hospital operated by a state-licensed mental health provider
What are your hours of operation? May I pick up my records?
Yes, medical records can be picked up in person and must be paid for by cash or check only. Once you are notified that your records are ready, you may collect them at our Cedar Knolls location at 218 Ridgedale Ave, STE 101, Cedar Knolls. Pickup hours are Monday through Thursday from 9:00 am to 7:30 pm, Friday from 9:00 am to 3:30 pm, and Saturday from 10:00 am to 1:30 pm (EST).
How can I check the status of my medical record request?
Please contact the Medical Records Request Line 973-538-7700 ext. 126.
Can I access my records through the patient portal?
Yes, you can have a “care summary” of your health record 24-48 hours after a scheduled office on the patient portal. For a more detailed “encounter summary” you would need to request this through the above form.
Can my x-rays be faxed or emailed to a physician or myself?
No. Unfortunately we do not have the capability to fax x-rays or email x-rays.