Release of Information Procedures

The radiology release of information department is open Monday through Friday, 8AM -4:30PM. Our staff can be contacted at 859-258-4047.
 

Our mailing address is:

Lexington Clinic Radiology Release of Information 1221 South Broadway Lexington, Kentucky 40504

• We request that you allow a minimum of 48 hours to process your request for
  the release of radiology films.
• It is the policy of the Lexington Clinic Radiology Department that only original
  radiographic images will be released.
• All films are released for a period of 30 days.
• If you are requesting copies of your films for your own personal use, there will
  be a $12 charge per sheet of film requested. To receive an exact cost on the
  copying fee, you will need to contact the radiology release of information
  department.
• Radiology films that are loaned out for pick-up will be waiting at the radiology
  check-in desk on the 1st floor of the main building at 1221 South Broadway.
• If picking up films, proper identification and /or written authorization from the
  patient will be required prior to the films being released.

Written Requests
Requirements of written authorizations:
• The authorization must be addressed to the Lexington Clinic.
• The authorization must specifically identify the patient.
• The authorization must specifically identify the recipient of the information.
  Medical record information will not be released to a person who is not indicated
  on the release form.
• The authorization must specifically identify the information to be released.
• The authorization must be signed by the patient or his legal representative.
• The authorization must be received within one year of the date of the signature
  and the date of the request for information.
• The authorization must indicate if the films are to be picked up by the requestor
  or mailed to the address given.

Who can sign a patient authorization?
• Patient
• Legal representative
• In the case of a minor (under 18 years of age), the parent or guardian should
  sign the authorization.
• In the case of a minor (under 18 years of age) whose parents are divorced, the
  custodial parent should sign any authorization.
• In the case of a disabled patient, the Power of Attorney can sign the
  authorization, but a copy of the POA must accompany the request.
• In the case of a deceased patient, the administrator or executor of estate
  can sign the authorization.

Verbal Requests
• When a verbal request (phone call) is received for the release of medical
  information, the requestor is informed that a release of medical information
  authorization form will be required prior to processing of the request unless the
  films are to be picked up by the patient. If the films are to be picked up by the
  patient, the request can be processed and a release of information signed by
  the patient at the time of pick up. If films are to be mailed, the release form can
  either be faxed or mailed to the Lexington Clinic.
• Complete information is required to process the request. The same information
  required of written authorizations is also required for verbal requests.