Pediatric Associates of Dallas
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PAD has a board certified lactation consultant and several lactation educators on staff.
Please bring your insurance card every time you bring your child to the office. It is needed if your child has to have testing performed by facilities not associated with PAD.


PAD Release of Medical Records Policy

In keeping with this practice’s duty to protect patient confidentiality, we will not release confidential medical information without strict adherence to state and federal laws, rules, and regulations.

Original medical records are the property of the treating physician and as such will not be released from this facility unless in accordance with a court order, subpoena, or statute. Original medical records are never allowed to leave this facility without prior authorization and approval by the treating physician(s).
This facility recognizes the right of patients to obtain copies of their medical records or have them forwarded to another designee such as a relative, physician, or attorney.

A fee of $25 is charged for copying, mailing, or otherwise complying with any approved request for the release of medical records in accordance with limits set by the Texas State Board of Medical Examiners.


 
Form
Description
PAD_Labs_Form.pdf  [13.64K]

Authorization Forms

Oral requests for the release of medical records will not be honored. Any patient requesting release of his or her medical records must complete the attached Medical Records Release Form. Alternative release forms will be accepted only at the discretion of the office manager and/or Medical Records staff.

A parent or legal guardian will be required to sign the Medical Release Form when the patient is a minor. No other persons will be permitted to sign a record release in lieu of patients without a court order or similar legal directive.

The patient, or other person authorized to consent, has the right to withdraw consent to the release of any information. Such withdrawal must be in writing. No information should be released after consent has been withdrawn.

A copy of the written Medical Records Release Form must be retained and placed in the patient’s permanent medical record.


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