Saint Clare’s Patient Admissions

Open Admissions Policy: It is, and has always been, the policy of Saint Clare’s Health to admit all persons without regard to race, color, creed, sex, sexual preference, age, physical and mental handicap, national origin, social or economic status. All medical center facilities are available to patients and visitors without discrimination.

Patient Admissions Procedure: When you register as an inpatient, you will be issued a special identification wristband, which must be worn at all times until you are discharged from Saint Clare’s Health. Note: The information on your chart is permanently recorded and is released only with written consent, except where required by law.

Admissions

Patient Consent for Treatment Forms: These forms must be completed and signed by the patient or appropriate surrogate prior to treatment or therapy. The forms are designed for the protection of the patient as well as Saint Clare’s Health. Please read these forms carefully and feel free to ask any questions you may have before signing.

Patient Medical Records: Following your visit or stay at Saint Clare’s, you may need to obtain a copy of your medical records or authorize Saint Clare’s to disclose your health information.

In order to comply with state and federal regulations for release of information, Saint Clare’s requires a valid, written authorization to be completed and signed by the patient before information may be released. For your convenience, Saint Clare’s has developed a Release of Information authorization form, which is also available in Spanish. To request a copy of a medical record, please print and complete the entire form, taking note of the following information:

Patient’s name, date of birth, and social security number
Purpose for release
Specific information to be released
Date(s) of service
To whom the records are being sent (name/address)
The patient/legal guardian’s dated signature

Mail or fax the completed form to:

Saint Clare’s Health Information Center
400 West Blackwell Street
Dover, NJ 07801
Fax: 973-989-3129

Timing

State and federal law allows up to 30 days to process this request, although we cannot guarantee a specific date prior to 30 days, all efforts will be made to provide the requested information in as timely manner as possible.

Fees

State and federal laws allow fees to be charged for the retrieval and copying of records. You will be informed of any such fees prior to the actual copying and release of information.

For more information regarding requesting copies of patient medical records, please call Saint Clare’s Health Information Center (Patient Records):

Denville……….973-625-6507
Dover………….973-989-3660