{"id":15555,"date":"2012-01-06T12:50:44","date_gmt":"2012-01-06T17:50:44","guid":{"rendered":"https:\/\/www.bu.edu\/dental\/?page_id=15555"},"modified":"2024-06-25T12:35:28","modified_gmt":"2024-06-25T16:35:28","slug":"dental-records","status":"publish","type":"page","link":"https:\/\/www.bu.edu\/dental\/patient-care\/dental-records\/","title":{"rendered":"Dental Record Request"},"content":{"rendered":"\n\n\n
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Not a patient<\/span>?<\/strong><\/h2>\n

Third parties can submit their requests via email by clicking below<\/span><\/p>\n

Click Here<\/a><\/strong><\/p>\n<\/div>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

How to Request a Copy of your Dental Record (Protected Health Information)<\/strong><\/h2>\n

To obtain a copy of your dental record, you should submit a signed and dated\u00a0Authorization to Disclose Dental Records Form (links\u00a0to forms are located below). Dental records can include medical history, pathology, radiology, lab reports, and other sensitive information such as genetic testing, sexually transmitted diseases, and HIV test results, etc. and are further protected by federal laws. Therefore, if you would like such information to be released, you must specifically indicate so on our authorization form by initialing the respective category of information.<\/p>\n

Form Instructions: <\/strong>Your dental records request form will be submitted automatically once you complete your electronic signature. You should receive a notification within two business days that your request has been received, and you can expect to receive your records within 1-2 weeks, but no later than 30 days, of the initial request date.<\/p>\n\n\n\n\n\n\n\n\n\n\n
English<\/td>\nAuthorization to Disclose Dental Records Form (EN)<\/a><\/td>\n<\/tr>\n
Espa\u00f1ol<\/td>\nAuthorization to Disclose Dental Records Form (ES)<\/a><\/td>\n<\/tr>\n
Portugu\u00eas<\/td>\nAuthorization to Disclose Dental Records Form (PT)<\/a><\/td>\n<\/tr>\n
Fran\u00e7ais<\/td>\nAuthorization to Disclose Dental Records Form (FR)<\/a><\/td>\n<\/tr>\n
\u0939\u093f\u0902\u0926\u0940<\/td>\nAuthorization to Disclose Dental Records Form (Hindi)<\/a><\/td>\n<\/tr>\n
Krey\u00f2l<\/span><\/td>\nAuthorization to Disclose Dental Records Form (Haitian Creole)<\/a><\/td>\n<\/tr>\n
\u4e2d\u6587<\/td>\nAuthorization to Disclose Dental Records Form (Chinese)<\/a><\/td>\n<\/tr>\n
Kabuverdianu<\/td>\nAuthorization to Disclose Dental Records Form (Cape Verdean Creole)<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
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Contact Information for Division of Dental Records<\/strong><\/h2>\n
\n

 <\/p>\n

Boston University Henry M. Goldman School of Dental Medicine
\nDivision of Dental Records
\n635 Albany Street, Suite 345
\nBoston, MA 02118<\/p>\n

Phone:<\/strong> 617-358-3403<\/a>
\nEmail: <\/strong>dentalrecords@bu.edu<\/a>
\nFax:<\/strong> 617-358-0327<\/p>\n

Business Hours<\/strong><\/h5>\n

If you are calling after hours, please leave a message, and your call will be returned as soon as possible<\/b>.<\/strong><\/p>\n

Monday\u2013Friday, 8 a.m. to 4:30 p.m.<\/p>\n<\/div>\n

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<\/h3>\n

Frequently Asked Questions<\/strong><\/h2>\n

How long will it take to receive my records?<\/strong><\/h3>
\n

HIPAA allows 30 calendar days to provide a patient with their records. If GSDM cannot provide access within 30 calendar days, HIPAA allows the time to be extended by an additional 30 days. However, records request team members should strive to provide records within 10 working days of a patient\u2019s request. Please contact the records department at 617-358-3403 or email us at dentalrecords@bu.edu if you need urgent records.<\/span><\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

How will I receive my records?<\/strong><\/h3>
\n

You or your approved designee will receive a secure email link to your requested dental records. You will have 30 days to download your records after which time you must submit another request to re-release your records. If you want\/need your records released in another method, please specify in the record release form above.<\/span><\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

Can I request records for someone else?<\/strong><\/h3>
\n

A patient\u2019s personal representative also has the right to request a patient\u2019s records and will be treated as if the patient is the one making the request. The personal representative should provide documentation that they: (a) have a health care power of attorney; (b) are the court-appointed legal guardian; (c) have a general power of attorney that includes the power to make health care decisions; or (d) are the executor or administrator of the estate.<\/span><\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

Will I be charged for my dental records?<\/strong><\/h3>
\n

No, there is no charge to receive dental records.<\/span><\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

Can I have my records sent to another clinic & myself?<\/strong><\/h3>
\n

Yes, you can request to have a copy of your dental records sent directly to another clinic and a copy sent to yourself as well.<\/span><\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

Can a provider request my records?<\/strong><\/h3>
\n

Yes, your dental\/medical provider can submit a request for patient records. We will need to verify that the request is for the correct patient, so they will need to provide three identifiers about you (such as, your full name, date of birth and mailing address) prior to us providing them with information.<\/span><\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n

How else can I request my dental records?<\/strong><\/h3>
\n

If you are unable to fill out the Dental Records release form above, you can request a copy of your dental records by calling us at 617-358-3403, emailing us at dentalrecords@bu.edu<\/a>, faxing us at 617-358-0327, asking in person at the dental school, or sending a written request to Records Department, 635 Albany Street, Suite 345, Boston, MA 02118.<\/span><\/p>\n

<\/div>\n<\/div>\n<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Not a patient? Third parties can submit their requests via email by clicking below Click Here How to Request a Copy of your Dental Record (Protected Health Information) To obtain a copy of your dental record, you should submit a signed and dated\u00a0Authorization to Disclose Dental Records Form (links\u00a0to forms are located below). Dental records […]<\/p>\n","protected":false},"author":4470,"featured_media":0,"parent":228,"menu_order":17,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/dental\/wp-json\/wp\/v2\/pages\/15555"}],"collection":[{"href":"https:\/\/www.bu.edu\/dental\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bu.edu\/dental\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/dental\/wp-json\/wp\/v2\/users\/4470"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/dental\/wp-json\/wp\/v2\/comments?post=15555"}],"version-history":[{"count":50,"href":"https:\/\/www.bu.edu\/dental\/wp-json\/wp\/v2\/pages\/15555\/revisions"}],"predecessor-version":[{"id":58267,"href":"https:\/\/www.bu.edu\/dental\/wp-json\/wp\/v2\/pages\/15555\/revisions\/58267"}],"up":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/dental\/wp-json\/wp\/v2\/pages\/228"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/dental\/wp-json\/wp\/v2\/media?parent=15555"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}