Health Information
Management

Our mission will assure that each patient has a complete and secure medical record which accurately reflects the care received. As stewards of confidential patient data and medical information, the Health Information Management team will commit to provide service in a timely and effective manner.

The medical treatment that you received during your care at Voorhees Pediatric Facility are documented and maintained in medical record file(s). Also included are physician notes from examinations, treatment and medications, and observations made by nurses and other members of your healthcare team. This information is combined to make up your medical records.

How to Obtain Copies of Medical Records?

A request for medical records may be made by returning an Authorization for Disclosure of Health Information via email to HIMROI@forkidcare.com or fax to (856) 810-3747.
You may also mail your request to:

Voorhees Pediatric Facility Health
Information Management Department
1304 Laurel Oak Rd.
Voorhees Township, NJ 08043.

The Authorization for Disclosure of Health Information form for patients under 18 years of age must be signed by a parent or legal guardian.

A valid authorization must contain the following information, or the request will be returned:

  • Patient’s full name and date of birth
  • Specific information being requested (e.g., type of report/information and dates of service, etc.)
  • Purpose for which the information may be disclosed
  • To whom the information should be sent (name and address)
  • Authorization expiration date
  • The patient’s signature or a patient’s legal representative’s signature
  • Date of signature

Records for all purposes except continuing care are subject to copying charges in accordance with Federal and NJ State Law. An invoice will be delivered to you, and payment will be expected prior to the records being delivered.

Page(s)

1-100
101- or greater

Fee

$1.00 per page
$0.25 per page

Instructions on how to request an amendment to your PHI/medical record

Please submit the completed HIPPA FORM (Download below) via email, fax or mail:

Email

Fax

Address to Mail

Voorhees Pediatric Facility Health
Information Management Department
1304 Laurel Oak Rd.
Voorhees Township, NJ 08043.

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