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Forms

What is a Patient Health Record?
How do you access a patient health record?
How do I correct my personal health information?
Authorization to Release Personal Health Information
Privacy-Personal Health Information
Contact Patient Records

Please print, fill-in and deliver or mail the original to:

Release of Information Staff
 Patient Records Department
Hotel Dieu Hospital
166 Brock Street
Kingston, ON K7L 5G2

Email requests are not accepted. To expedite your request, you may fax your form to
613-542-8071.

Forms are posted as pdf files and you will require Adobe Acrobat Reader to open them.

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Religious Hospitallers of Saint Joseph of the Hotel Dieu of Kingston
HOTEL DIEU HOSPITAL, 166 BROCK STREET, KINGSTON, ON, CANADA, K7L 5G2

Local patients and families are asked to dial: 613-544-3310 (Switchboard) or 613-544-3400 (automated attendant).

Long-distance patients and families can dial toll-free at 1-855-544-3400.

Thank you for your interest in the Hotel Dieu Hospital. The information provided is general in nature. Specific health care questions are best discussed with your family physician.

This page has been visited -- times as of September 30, 2011

This page is © Copyright 2011, Hotel Dieu Hospital