You may make an informal or formal request. Please use the Middlesex Hospital Alliance FOI Request Form to make a formal request. Under FIPPA, an FOI request must be in writing and must provide sufficient details to identify the information.
A $5 fee for making a FOI request is also required under the Act. Please include a cheque or money order payable to the applicable site, either Four Counties Health Services or Strathroy Middlesex General Hospital, along with your completed request form. Please do not mail cash. Mail your completed Request Form and cheque for $5 to:
Andrea Wilkinson, CHIM
Chief Privacy Officer, Manager, Health Information Services, Patient Registration, Community Support Services
Middlesex Hospital Alliance
395 Carrie Street Strathroy, ON N7G 3J4
If you have any questions, please call 519-245-5295 x2554
If you are submitting a request to access personal health information please submit a MHA Consent for Access or Disclosure of Personal Information or Personal Health Information. The starting fee for this type of request is $5.00
Please note that requests received by electronic mail (e-mail) are not accepted since the legislation requires that requests be authenticated by an original signature. Requests received by electronic mail cannot be processed without receipt of the original in hard copy format and $5.00 fee.
Please remember to be as specific as possible in describing the records you are requesting. Upon receipt of a written request, an acknowledgement letter will be sent to the requester. If the request does not sufficiently describe the record sought, the FOI coordinator will contact the requester for clarification. Please ensure that you provide a telephone number where you can be reached during the day.
The MHA will make every reasonable effort to respond within thirty days after a complete request has been received. If you are requesting records for another person, you will have to provide sufficient proof that you have the authority to act for that person.
Informal Request
The Middlesex Hospital Alliance promotes access to information and transparency of its governance and decision making. In many cases the information you seek may already be available, for example, here on our website. Before making a formal request for access to information, contact the FOI coordinator to see if the information you are seeking can be processed through an informal request. If the information is readily available, the FOI coordinator will direct you to the information, or where appropriate, send the information to you. By contrast, a formal access request can take 30 days or more to process and will result in fees.