How to Obtain/Secure a Medical Release of Information for an Incarcerated Individual in PA State Prison

By Elaine Selan, RN, MSN

Our current health crisis is one that impacts each of us in different ways; it brings to light so many questions and concerns.  Often as nurse who is also a human rights activist, I am contacted by family members asking how one can obtain medical information about a loved one who is incarcerated.  Typically, this need arrives when the loved one becomes ill.  However, getting a Release of Information [ROI] when your loved one is not ill will make it easier to get information if the need occurs.

The process has many steps; and, even if followed correctly, the DOC’s health services may present obstacles that need to be addressed.  Determination is crucial!!! 

Key Information

The DOC ROI only applies to medical care provided by DOC Health Care Services.  IF your loved one is hospitalized at an external hospital [overnight visit], that information will need to be requested and obtained from the hospital medical records department—the hospital’s ROI form will need to be completed. See #6 Section below.

Following is a step-by-step procedure for obtaining, completing and implementing a DOC-approved Release of Information [ROI] that will allow prison medical staff to provide information about an incarcerated person’s health status to those person[s] he/she has given signed consent. 

  1. It is vital that a ROI be on file at the prison at all times while the person is incarcerated
    • A copy of the ROI should be kept by the outside person who is designated to receive health care information.
    • If you wait until your loved one has a health care “situation” or crisis, it is likely that you will not have access to his or her current condition.
  2. The DOC’s ROI is only valid for 180 days from the date of the person’s signature. That means that a new ROI must be completed twice a year! 
  3. More than one ROI can be completed so that more than one person can receive health information. 
  4. The incarcerated person needs to initiate the ROI process, not the outside family member, a loved one or requesting health care provider.
  5. If you are the ROI “requester” [the person who will receive the information] and you request paper documentation from health services [for example, lab test results], there is a duplication cost associated with this request. 
  6. Note that the ROI form only allows the prison to release information but does not extend to an outside health care provider, UNLESS the test or procedure is now part of the prison’s health care record.  A separate ROI must be completed at the health care location, where treatment is being provided.  For example, if one is admitted to “Hospital X”, the hospital’s ROI form must be completed and submitted to “Hospital X” Medical Records Department.  The “patient” [incarcerated person] must sign that Hospital’s ROI Form.  It is better if this is done while the person is hospitalized, if possible.  
  7. A new ROI is needed if the individual is transferred to another prison.
  8. The ROI Example [found at the end of this handout] is not official.  The official version has tear-off duplications, so the completed and signed form can be sent to the necessary recipients.  The official version is available in English and Spanish. 
  9. If the person is unable to complete the form, someone else can assist in completing the form and then it can be signed by the incarcerated individual. 

Step-by-Step Process

Advance Directives

An Advance Directive [or “Living Will”] is a document that ensures that one’s wishes are followed if one becomes incompetent and in a terminally ill condition; or, in a state of permanent unconsciousness.  This document allows the signer to choose someone [a surrogate] to make medical decisions on their behalf.   One can decide specific types of treatment that are not to be used and when to use the surrogate to make those decisions on the signer’s behalf.   If your loved one has signed an Advance Directive it is important that the assigned surrogate have a copy of the Directive.  A ROI is not required in order for prison health services to contact the surrogate if one’s condition meets the Advance Directive conditions.  If the person is transferred to an outside health care provider, they are likely to also honor the signed Advance Directive.  There is no time limit on this document; however, it can be changed or removed at any time, at the signer’s request. 

How to Obtain Medical Information

Steps to obtain medical information from DOC Health Services:

  1. Obtain PA Standard Right to Know Form from
  2. Complete form [see sample form]
    1. There are fees for printed copies; see Official RTKL Fee Schedule.
  3. Contact Prison-obtain fax phone number for Health Services Medical Records Department.  Obtain name of MR Supervisor, if possible.
  4. Fax both forms [Standard Right-To-Know Form and DC108 ROI Form]; address to “MR Supervisor”.
  5. You will need to do phone call follow-up as often as necessary. 

ROI Example

Examples of “Information being requested”. If an item is not listed, the information will not be released. Suggestion: include all information items!

  • Medical History
  • Diagnosis or Diagnoses
  • Lab Test Results
  • Radiology Test Results
  • Procedure Results
  • Prognosis
  • Treatment
  • Medications
  • Progress Notes
  • Treatment/Aftercare Plan







                                                                                                             3/24/2020 egs (c)

2 thoughts on “How to Obtain/Secure a Medical Release of Information for an Incarcerated Individual in PA State Prison

  1. Hello my brother was arrested on march 14 2022 and family has called the prison hospitals and no one will give us answers my mom is 90 and its taking a toll on her health is there anyway i can get some kind of information my number is 5708151001 cheryl would gladly appreciate it very concern!!!! Carl fisher scranton pa 18509

  2. Hi Cheryl, I’m so sorry for my delayed response. We’re an all volunteer group and we’re only able to put out the newsletter four times a year and respond to health questions. I hope that you have found some information and that your brother is doing well. That must be so stressful and upsetting. I know how to find people in the “inmate locator,” but other than that I don’t have much knowledge about how to find people and information from the prison system or the jails. —Suzy, co-editor of Prison Health News

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