LUG: Release of materials
A valid patient release or authorization, signed by the patient, guardian, or personal representative, is required. A court subpoena alone is not sufficient for the release of patient materials.
Henry Ford Health System Hospitals
Legal Request
Legal Request for Slides and Reports: A HIPPA Compliant Patient Release form must be signed before any slides or reports can be released.
Tissue: An Affidavit of Permanent Release of Pathology Materials form must be filled out prior to the release of any tissue.
The forms can be obtained by telephone at (313) 916-2964 or by fax at (313) 916-9113, Monday through Friday, 7:30 a.m. to 4:00 p.m.
Consultation Request
Slides and Reports: A Patient Release form must be signed before any slides or reports can be released or mailed outside for consultation at an external party’s request (e.g. patient, Non-Henry Ford institution, etc). Forms may be obtained by telephone at the numbers listed below for each Henry Ford Health System Hospital. Twenty-four hours notice is requested for slide preparation.
- Henry Ford Hospital – Main (Detroit)
Telephone: (313) 916-3953
Fax: (313) 916-9433
Hours of availability are Monday through Friday, 8:00 a.m. – 4:00 p.m.
- Henry Ford Hospital – Macomb (Clinton Twp.)
Telephone (586) 263-2460
Fax: (586) 263-2258
Hours of availability are Monday through Friday, 9:00 a.m. – 5:00 p.m.
- Henry Ford Wyandotte Hospital
Telephone: (734) 246-9786
Fax: (734) 246-6918
Hours of availability are Monday through Friday, 8:00 a.m. – 4:00 p.m.
- Henry Ford Hospital – West Bloomfield
Telephone: (313) 916-3953
Fax: (313) 916-9433
Hours of availability are Monday through Friday, 8:00 a.m. – 4:00 p.m.
- Henry Ford Jackson Hospital
Telephone: (313) 916-3953
Fax: (517) 205-7295
Hours of availability are Monday through Friday, 7:30 a.m. - 4:30 p.m.
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