To request Personal Health Information (PHI), including medical records, x-ray images and MRI images, please follow the steps below:

Fill out a “Request to Access Personal Information” form.  Please complete all information in pen.

• If you cannot print the form, please phone the Health Information Services Department at 204.925.1543 and we will fax or mail the form to you.  You may also present in person at the Health Services Information Department to fill out the form.
• It is important to specify the type of information that you are requesting.  Where applicable, indicate any of the following to assist us in identifying the information you need:
  • Date range
  • Name of health care provider(s)
  • Body part(s) affected
  • Type of information needed (i.e. MRI report, clinic notes, lab results, etc.)
• Authorization – The request will not be processed without proper authorization.  Please sign and date the form on the line beside “Signature of Applicant”

Submit your request by mailing it to:

Pan Am Clinic
Health Information Services
75 Poseidon Bay
Winnipeg, MB
R3M 3E4

You may fax your request to 204.925.7484

You may drop off your request at the Health Information Services desk during business hours (Mon to Fri: 8:00 am – 5:00 pm).  We are located in the lower level of the Pan Am Clinic.

Processing Fees are: $25.00 Administrative Fee PLUS $0.50 per copy (paper records).

The processing fees for obtaining copies of your records are $25.00 administrative fee PLUS $0.50 per copy (paper records).

The Health Information Services department accepts cash (exact change please), debit card, credit card, or cheque payable to “Pan Am Clinic”.