Your Health Records

The Mosaic Primary Care Network (PCN) complies with the Alberta Health Information Act and other related provincial legislation for the collection, use, and disclosure of your health information. We respect and maintain the confidentiality of your health information. The Mosaic PCN Health Records Information Release Specialists and Privacy Officer manage release-of-information inquiries and requests for copies of your personal health record. 

FAQ 

                   
How can I get a copy of my health record? 
If you are a current or former patient of a Mosaic PCN clinic, you can request your records by submitting a dated, written, and signed (by you and your witness) original request to our Sunridge Medical Clinic (Sunridge Mall 2525 36 Street NE, Calgary, AB T1Y 5T4), using this form: MPCN Consent for Disclosure. 

What should the request include? 
Please complete the MPCN Consent for Disclosure form. Requests must include your name, date of birth, mailing address, and the type of information you need. The request must be dated witnessed and signed by you and another person (witnessed). Once completed please submit your form in person to our Sunridge Medical Clinic (Sunridge Mall 2525 36 Street NE, Calgary, AB T1Y 5T4).

Does it cost me anything to request my health record? 
There is no cost for requesting your health records. 

How long does it take to process my request?
Requests for health information will be processed within 30 calendar days from the date we receive your request.

What if I want my records released to someone else? 
Each request for health records is handled individually. The most common requests come from health care professionals, third parties, or relatives and friends acting on your behalf. These are managed as follows:

• Healthcare Processional: submit request with patients signed consent giving Mosaic PCN authorization to release your information. 
• Third parties (ie. Law firms, Insurance companies): Requests must be submitted to the Health Records team via fax at 403-250-5244.
• Relative or Friend: Patients must submit a signed consent giving Mosaic PCN authorization to release your information, please note the  MPCN Consent for Disclosure form will need to be completed as well.

What if I am inquiring about records for a deceased patient? 
For patients who are deceased, proof of trustee/executor of the estate, or legal signing authority, must be submitted with your with the signed MPCN Consent for Disclosure form. Please note that if you have Power of Attorney for Personal Care for a deceased patient, it expires upon death. 

How can I obtain records for an incapable/incompetent patient? 
For patients who are incapable of signing a consent, proof of legal signing authority must be provided with the signed MPCN Consent for Disclosure form. Proof of legal signing authority such as the Substitute Decision Maker may also include the patient’s legal guardian, Power of Attorney for Personal Care, spouse or partner, parent, child, sibling or other relative.

What if I have any questions or concerns about my Health Records once I receive them?
If you have any questions or concerns about your health records after receiving them, please contact Mosaic Primary Care Network’s Privacy Officer. You can reach them by phone at 403-250-5059 or via email at privacy@mosaicpcn.ca.

For any further information regarding Mosaic Primary Care Network’s privacy protection practices please contact the Privacy Officer at privacy@mosaicpcn.ca