My Health Records

Reviewing or Obtaining Health Information

Patients are entitled to access their health information/health records. These records can be accessed once proper consent and required authorization has been obtained. Our Health Records staff are unable to interpret or counsel on health issues or documentation in the records. It is recommended that your health information be reviewed in conjunction with your family physician or health care provider.

Records are processed according to medical priority sequencing and will be completed in a timely manner.

Requesting a copy of my West Haldimand General Hospital health record

All requests must be made in writing by completing an authorization for release of information consent form. This provides the hospital permission to disclose, transmit, access or examine your personal health information.

West Haldimand General Hospital – Authorization for Release of Information 

Your request must include:

  • Patient name, address, contact information and date of birth
  • Dates of Hospitalization or Contact (if exact date is unknown please provide an approximate range)
  • Name, address and contact info of recipient (person or institution to whom the information may be disclosed to
  • Purpose of request (eg. Further treatment, legal request, family records etc.)
  • Original signature of patient, substitute decision maker (SDM) or legal representative
  • Date of authorization
  • Original witnessed authorization (signature of person verifying that the patient or SDM did in fact sign the authorization)
  • Prepayment (if required – see fee schedule below)

Completed forms can be mailed to:
West Haldimand General Hospital
Attention: Health Records Department – Release of Information
75 Parkview Road
Hagersville, ON
N0A 1H0

Fee Schedule

There is no fee for information given to other health care facilities or physicians for continuity of patient care.
For other purposes, an administrative charge may apply based on the current fee schedule.
Prepayment is required.

Request Type Fee Additional Cost
Patient access / personal use $30.00 first 20 pages $0.25/page thereafter
Letters: Proof of Death, Confirmation of Attendance, Visit History $30.00
Lawyers (Incl. Legal Aid, Child & Family Justice etc.) $30.00 first 20 pages $0.25/page thereafter
Completion of Forms E.g. Pension Forms, Insurance Forms, Compassionate Leave Forms $30.00
Insurance Companies, Consulting Firms, Rehab Agency $160.00 first 20 pages $0.25/page thereafter

*Other request types: please inquire with Health Records Department – Release of Information.

Additional Fees:

  • Rush Surcharge or Same Day Requests – within 1 to 5 business days $200.00
  • Special Courier or Shipping Fees (Determined during request) to be paid by requestor

When can I expect my request to be completed?
In accordance with the “Personal Health Information Protection Act” PHIPA, West Haldimand General Hospital has up to 30 days to process a request once completed required documents/consents are obtained.

PHIPA Section 54(2) — Time for response:
(2) Subject to subsection (3), the health information custodian shall give the response required by clause (1) (a), (b), (c) or (d) as soon as possible in the circumstances but no later than 30 days after receiving the request. 2004, c. 3, Sched. A, s. 54 (2).

The WHGH Health Records Department manages the collection, storage, retention and access to your personal health information record. We respect and maintain the confidentiality of your personal health information. Our Health Information Management Professionals are educated and trained to handle inquiries and process requests for access, corrections and/or release copies of your personal health information record, in accordance with current legislation.

To learn more about how we use and protect your information, read our Statement of Information Practices and Collection of Personal Health Information.

Frequently Asked Questions

Does the hospital have all my health records on file?

The West Haldemand General Hospital retains and manages patient records according to current government legislation.

How do I request birth information?

If you want birth information for yourself or your child (i.e.: proof of birth, time of birth), please include the mother's name, mother's date of birth and child's date of birth. Health Records will issue you a "Proof of Birth" letter, stating a baby boy/girl was born at the hospital, date born, Mother's name, and delivering Physician's name. (This is not an official birth certificate) This information may be used to apply for your official birth certificate. An application can be made by calling the Office of the Registrar General, Thunder Bay, ON, toll-free at 1-800-461-2156, or by applying on-line at

How can I obtain records for an expired patient?

For patients who are deceased, proof of trustee/executor of the estate, or legal signing authority, must be submitted along with your written/signed request.

Copies of a medical death certificate cannot be provided, in compliance with the 'Vital Statistics Act'.

Health Records will issue you a "Proof of Death" letter, stating date of death, cause of death and hospital location. This information can be used to apply for a Medical Certificate of Death. Application can be made by calling the Office of the Registrar General in Thunder Bay, ON, toll free at 1-800-461-2156, or by applying on-line at

How can I obtain records for an incapable/incompetent patient?

For patients who are incapable of signing consent, a proof of legal signing authority must be provided to Health Records with the written and signed consent form. Proof of legal signing authority such as the Substitute Decision Maker (Public Trustee) may also include: the patient's legal guardian, Power of Attorney for Personal Care, spouse or partner, parent, child, sibling or other relative.

Can my family and friends reach me while I'm in hospital?

Your family and friends may call and request information on your location in hospital. If you do not want this information given out, please tell the registration staff at the time you are being registered for admission.

Need to contact the Health Records Department?

Health Records Department:

By Phone: (905)-768-3311 Ext. 1175 or Ext. 1177
By Fax: (905)-768-4134
Hours of Operation: Monday – Friday, 8:00 am to 4:00 p.m.

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