Your Health Record

Authorization Forms

Authorization for Disclosure of Medical Record Information
If you were a patient of University Health Network (former Toronto Hospital), you can receive a copy of your health records by completing this form and faxing it to the appropriate hospital's fax number (listed below).

Administrator to Administrator Request Form
This request form can be used by a hospital administrator or a representative of the administrator to obtain copies of a patients' medical record in order to treat the patient when he/she is deemed incapable of giving consent.

Please Note: There is an administrative cost for non-medical requests. A pre-payment fee must be submitted with your written request. For a list of costs, download the fact sheet for release of information fees .

For more information on University Health Network's release of information procedures and policies, contact Health Record Services:

The release of information office is open Monday to Friday, 8:00 am to 5:00 pm.

Please Note: Health Record Services requires the original signed authorization form in order to complete your request.