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OAM is committed to managing your medical records in a safe and secure manner while keeping your Protected Health Information private and giving you timely access to your health information.

Release of Medical Information

OAM is required by law to have a signed authorization from all patients prior to disclosure of their medical information to any outside source.

Most Disability forms or Family Medical Leave Act (FMLA) forms include an authorization to disclose information page or paragraph to be signed by the patient.

If your forms contain a section authorizing release of information complete that section and sign and date where indicated.

If your forms do not include an authorization page or section, you will be required to sign our OAM medical release form (see pdf on this web page). Please note this includes FMLA for your spouse or relative as well.

There is a fee for completing and processing forms. For information on charges, please see FAQ section below. 

Frequently Asked Questions (FAQ)

Is there a fee for completing and processing forms?

Yes. The OAM office charges $25 for the first form, and $15 for each additional form. This must be paid prior to release of information.

Can I have a family member drop off forms and pay the fee on my behalf?

Yes. A family member or friend may give us forms and make a payment for you; however, they MAY NOT SIGN on your behalf to release your information. For privacy reasons, only the patient can release their own information to another entity (such as an insurance company or an employer).

You may print and sign our Disability/FMLA Request form (see pdf above) at home if it would otherwise be difficult for you to come into the office in person. A family member or friend may present that form signed by you, the patient, along with the Disability or FMLA forms. They will need to also provide the payment for our office to complete the forms. That family member or friend should be prepared to answer a few simple questions regarding what the patient needs done with the forms when they are completed.

Can I request my medical release of information using the online Patient Portal?

Yes. If you have a Patient Portal account you can send a message directly to us that will serve as authorization to release information. Payment will still need to be submitted and we may need additional information before the forms are completed. If you don’t have a portal account call our office and we’ll send you a link to your email to get set up. This also allows you to easily access your medical records for the future.

How long does form completion normally take?

Our office sometimes takes up to 5 business days to complete the forms and notify you that they are ready for pick up or to send them out to your employer/insurance company.

Can OAM send in the forms for me?

Yes. We would be happy to send your forms in for you. We will require the fax number or mailing address (usually listed somewhere on the forms) and your signature on our Release of Medical Records Information form to serve as authorization for us to release that information on your behalf. There may also be a place on your Disability form that you can sign allowing us to release the information.

Why is there a fee?

These types of forms can be very complex and take time for our staff, including additional time from your provider, in some cases. For more information, read the Michigan Medical Records Access Act.

If employer faxed forms directly to OAM, do I still need to pay the fee?

Yes, even if forms are sent directly to OAM, you will still be responsible for the form completion fee. The fee is for the work and time involved in filling out the forms, not the form itself.