Request to Access PHI
To receive a copy of your personal health information in eChart Manitoba, please:
- Fill in the appropriate fields in the form below and sign at the bottom
- Send the signed and completed form to the address or fax number at the top of page two
If you have questions regarding these requirements, please contact eChart Manitoba at 1-855-203-4528. All forms must be signed originals received by mail or fax. You may be required to pay a fee per printed page.
For additional eChart information:
- Phone: 1-855-203-4528 (toll-free)
- Email: echart@sharedhealthmb.ca
- Web: echartmanitoba.ca
Other eChart forms are available to:
- See who has accessed your personal health information in eChart Manitoba (echartFrmPHI.pdf)
- Hide your clinical information in eChart Manitoba (formDisclosureDir.pdf)
Manitoba Health
To learn more about your personal health information rights, please visit: www.gov.mb.ca/health/phia
Manitoba Ombudsman
If you want to learn about your right to make a complaint related to your request to access your personal health information, contact the Manitoba Ombudsman office at:
750-500 Portage Avenue
Winnipeg, Manitoba R3C 3X1
In Winnipeg phone: 204-982-9130
Or toll-free: 1-800-665-0531
www.ombudsman.mb.ca