Health Information Management

Health/Medical Records at Otsego Memorial Hospital


Our centralized Health Information Management Department provides functional support to all components of the healthcare facility and the various departments with respect to health information services. These functions include:

  • Patient identification system
  • Creation and monitoring of health record documentation
  • Release of information, coordination of patient access to data, and response to court subpoena and depositions
  • Dictation/Transcription system
  • Special studies and financial reimbursement support data
  • Storage and retrieval system, including chart tracking system
  • Assistance in complying with legal and regulatory provisions and accrediting agency standards concerning healthcare data
  • Data security, privacy and confidentiality processes

To request a copy of your medical record, please download and fill out the Authorization for Release of Information form and return to Health Information Management.


Hours of Operation

Monday – Friday
7:00 a.m. – 5:00 p.m.


(989) 731-2224


(989) 731-6039



Nancy Kussrow, RHIA, CCS,


Health Information Frequently Asked Questions

  • Can you give me my medical information over the phone?

    No, we cannot. This is due to the need to protect patient confidentiality. We are not able to confirm identity over the telephone so we do not supply information over the phone. Additionally, we are not clinical personnel and cannot explain test results.

  • Who should sign a release of records for a minor child?

    Natural parents of a minor have an equal right to a child’s medical information, with certain exceptions, as required by law. They can only be denied access if they have been terminated of all parental rights. We must have knowledge of the lack of parental rights to facilitate the denial. When the natural parents have never married, unless otherwise ordered by a court order, only the natural mother has the ability to sign the release of information authorization. An Acknowledgement of Paternity does not provide to the father the authority to authorize the release of records. Stepparents, without an order of the court, do not have the necessary authority to consent to the release of the minor child’s medical records.

    An adoptive parent must provide the consent for the release and have copies of legal adoption papers of a minor child’s medical record.

    In instances where Michigan law allows a minor to consent to his/her own treatment without parental consent, only the minor has the right of access to those treatment records.

  • Can a parent sign a release for records for a patient that is 18 years old?

    No. The age of majority in Michigan is 18. Therefore, in order to legally authorize the release of information, the patient would have to sign for himself/herself, unless a legal guardian has been established by the court. Documentation of authority to sign for the patient must be provided.

  • Can my spouse get my medical records?

    No, only if they have a valid authorization, signed by you or your legal representative, that specifies that your medical records may be released to that particular individual. Medical records will not be released without an authorization except for continued patient care directly to a physician's office or healthcare facility or in the event of a medical emergency.

  • How do I find out my blood type?

    Your blood type may or may not be listed in your medical record. Your blood type was probably not tested unless you have had major surgery that may have required a blood transfusion. It will be necessary for you to complete the authorization form available from our office, or online, to request a copy of your blood type results.

  • How can I find out if I received a tetanus shot?

    Tetanus shots are usually given when there is an open wound. It will be noted in your record if you received a tetanus shot when in the hospital. You will need to sign an authorization to receive this information.

  • How can I get my complete shot record?

    For a comprehensive list of all shots you have received, contact the Gaylord Health Department at (989) 731-1219.

  • Can I get a list of my treatment dates?

    Yes, we can provide dates of service at your request. You should specify your request for dates of service on the release authorization form on the line designated as “Other”. Please be sure to list the time period you are looking for. There is no charge your dates of service request.

  • What if I need more information about obtaining copies of my medical record?

    Should you have any additional questions regarding requests for copies of your medical information, please contact our office from 8:30am to 5:00pm, Monday through Friday. We can be reached by phone at (989) 731-2224. Our fax number is (989) 731-6039.

  • How do I request my medical records?

    A written authorization form must be submitted to the Health Information Management Department.

    Once the form is complete, you can:

    • Submit it in person at the Patient Information Desk at OMH
    • Fax it to the HIM Department: (989) 731-6039
    • Or mail it to:
      Otsego Memorial Hospital
      ATTN: HIM
      825 N. Center Ave
      Gaylord, MI 49735


    Download Authorization Form
  • Where can I get the authorization for release form?

    A printable version of the Authorization for Release form can be downloaded from the button below.

    Download Printable 'Authorization Of Release' Form
  • How long will it take to process my record request?

    Patients requesting copies of records typically take no longer than 30 days to process. In the rare event of a delay, you will be informed accordingly.

  • How much will it cost to receive my medical records?

    For patients, the first 10 pages are free and then $0.50/page for anything after.

  • Am I able to sign a release if I am the Power of Attorney or Patient Advocate?

    No, unless it has been declared that the patient is incapable of understanding/exercising his/her rights and responsibilities and is unable to participate in medical treatment decision making by two licensed physicians and the appropriate form is on file.

    Download The 'Declaration of Incompetency' Form Here
  • How can I check the status of my medical record request?

    You may call (989) 731-2224 to check the status of your submission.

  • My doctor needs my records urgently, how can she get them?

    We need to receive a request from your physician indicating which records are needed. The request needs to be faxed to (989) 731-6039 or call (989) 731-2224. These requests are processed upon receipt.

  • Where do I pick up my records in person?

    Present to the Patient Information Desk at the OMH main entrance (the large revolving door) and they will contact the HIM Department. Please indicate to them that you called in advance.

  • What are your office hours?

    The office is open Monday through Friday, 8:00A.M. - 5:00P.M.

  • How do I request Radiology images?

    Please contact (989) 731-2175.

  • How do I request copies of billing records?

    Please contact the Billing Department at (989) 731-2198.

  • Can I review the official copy of my medical chart in person?

    Yes, we can schedule an in-person review for you. Call (989) 731-2224 to schedule a review. An authorization form will be completed at that time.

  • Can the request for my family's medical records be on one request form?

    No. A separate form must be completed and signed for each family member. For those family members who are 18 years of age or older, they will need to sign authorization or legal documentation must be provided when signing on behalf of the patient.

  • I found an error in my medical records. How can I have it corrected?

    We will review and respond to your request within 60 days.

    Download the Request to Amend form
  • Is all health information released through the HIM Deptartment?

    In most cases HIM directly handles the release of health information. The request will be forwarded to the appropriate department for items such as radiology films (or compact disc) and billing information.

  • Who may I call to inquire about records?
    • Billing records: (989) 731-2198
    • Radiology (including mammography) films: (989) 731-2175
    • OMH Medical Records: (989) 731-2224
    • Physician Office Records: Please contact the specific office you wish to find records for.
    • List Of Contacts
  • Will I need to present some form of identification?

    We require a copy of your driver’s license or official form of photo I.D. for records being released to the patient.

  • Can I request records if the patient is deceased?

    Items such as Durable Power of Attorney, or designation as decision-maker in an Advance Directive are no longer valid after the death of the patient.

    A deceased patient’s records can be released if appropriate documentation is provided. This will generally include documentation naming the person with legal authority to release the records (for example, a copy of the patient’s will, an affidavit of surviving spouse or court order) and a copy of the death certificate.

    If there is no legal representative, authorizations may be accepted in the order of priority from individuals in the following list:

    1. Spouse
    2. Adult son or daughter (with a signed affidavit of heir)
    3. Either parent
    4. Adult brother or sister

    Also, records on deceased persons can be sent directly to life insurance companies for purposes of payment of benefits.