Access to medical records

All applications for access to medical records should be addressed to the Medical Records Department. Every record is confidential, even after the death of the user. Users can personally access their records, under certain terms and conditions, and they can also authorize a third party to have access to their record.

THERE ARE TWO WAYS FOR YOU TO OBTAIN INFORMATION CONTAINED IN YOUR RECORD, OR HAVE IT SENT TO A THIRD PARTY:

1- A written application sent to the Medical Records Department of Wakefield Memorial Hospital, by mail or fax, at the following address:

Wakefield Memorial Hospital
Medical Records Department
101, chemin Burnside P.O. Box  160
Wakefield  QC  J0X 3G0
FAX: (819) 459-3947

You can print and fill out the form  “Autorisation de communiquer des renseignements contenus au dossier” [Authorization to transmit information contained in a user’s record] or you can compose your own application, which must contain the following information:

  • Your family name and first name;
  • Your date of birth;
  • Your parents’ names and first names;
  • Your phone number;
  • Your full address (so that we can mail the documents);
  • The documents you wish to consult and their dates (in order to avoid fees, make your application as specific as possible);
  • Your original signature and the date of your application;
  • Every application must be signed and dated by the user. A copy of an identification paper may be required.

2- In person
You can come in person and bring an identification paper with a photograph to the reception desk of one of our facilities during office hours (except on statutory holidays), in order to fill out and sign the authorization form, which will then be transmitted to the Medical Records Department.

Centre hospitalier Mémorial de Wakefield
101, chemin Burnside
Wakefield (Québec)  J0X 3G0

CLSC de Chelsea
490, route 105
Chelsea (Québec)  J9B 1L2             

CLSC Val-des-Monts
1884, route du Carrefour
Val-des-Monts (Québec) J8N 7N5

CLSC Cantley
850, Montée de la Source
Cantley (Québec) J8V 3H4

CSLC de Masham
9, chemin Passe Partout
Masham (Québec)  J0X 2W0


We will not give you any document on the day you sign the authorization form, and no personal information will be given verbally or by fax.

The Medical Records Department will then process your application in compliance with the laws and regulations in effect. There is no fixed date for delivery, but we  should give you access to your record as soon as possible (generally within 1 to 3 weeks).  Exception: the results of medical tests (blood tests, radiology...) cannot be provided sooner than 21 days after the date of the test.

Certain fees may apply, depending on the type of request and the number of documents requested, in compliance with the regulation in effect “Regulation respecting fees for the transcription, reproduction or transmission of documents or personal information”.

We will then send you the documents by mail. If you prefer to pick them up yourself, ask for this and you will be able to collect them when they are ready at the reception desk of the Wakefield Memorial Hospital.

For further information on the access application procedure, please call the Medical Records Department at the following number: (819) 459-1112  or toll-free at (877) 459-1112 ext. 2340