Mitcham Private Hospital
Part of Ramsay Health Care

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Accessing your Medical Record

Request for release of information

In accordance with the Health Record Act 2001 patients can request access to information from their medical record.

Once your application form has been received, a search will be conducted for the information you seek.

Under the Health Record Act 2001 and the Privacy Act 2014, Mitcham Private Hospital has 45 days to provide the requested information.

There are costs involved in providing this information and an invoice will be sent once an initial request is made.

Fees & Charges
Standard application fee: $38.20
Registered post: $15.00
Photocopying: $0.20 per page
Retrieval from secondary storage (if applicable) $18.30

Should you wish to make an application to access a medical record please complete the Application Form and post it together with a photocopy of photo identification (such as your driver’s licence) to:

Privacy Officer
Health Information Services
Mitcham Private Hospital
27 Doncaster East Rd 
Mitcham VIC 3132

Alternatively you can scan and email the completed form and photo identification to: