Request Medical Records

Medical records are maintained by Health Information Management (HIM) at Cherry Health. As a patient of Cherry Health, you have the right to obtain your medical records.

What’s in your Medical Record?

  • Results of all laboratory tests, X-rays, other diagnostic studies, and medical treatment you received while you were a patient
  • Physician reports from examinations, treatment and medications
  • Observations by nurses and other members of your health care team

Confidentiality of Care

Your medical record is treated as confidential by all hospital, medical and office staff members. No one may obtain a copy of your records without written consent except those required by law, transfer of care or third party payor/insurance contract.

How to Submit Requests and Receive Copies

To request a copy of your medical records (for personal use or for another healthcare provider), download, print and complete the Release of Information Authorization form. Once completed you may fax or mail your request to the location below.

  • Cherry Health and its authorized employees may only fax patient records to other healthcare organizations and/or physician offices.

We are unable to fax patient records to a patient home or places of employment. These requests MUST be picked up, we are unable to mail them.

Is There a Charge?

There is a charge for copies for personal use. There is no charge for copies sent directly to healthcare organizations and/or physician offices. Both state and federal law (HIPAA) permit healthcare organizations to charge a reasonable cost-based fee for reproducing records. Our fees are updated annually in July and are based on Consumer Price Index of Medical Records Access Act Fees from the State of Michigan’s Department of Community Health.

  • Pages 1-4………………………….$5.00 flat fee
  • Pages 4+…………………………..$0.50 per page

*Rates above reflect pricing for patients.

Payment is due at the time of pick-up.

For More Information

Please fax or mail your completed forms to:

Heart of the City Health Center
Attention: Health Information Management
100 Cherry Street SE
Grand Rapids, MI 49503

Phone: 616.965.8200
Fax: 616.940.5367