The College of Physiotherapists of Alberta has seen an increase in clients who are struggling to get access to their chart records in a timely manner or are being charged fees that do not align with legislation or the Standards of Practice. The goal of this article is to quickly outline the important aspects of chart access, so physiotherapists fully understand what their responsibilities are.
1.Clients get to access their health information.
Yep, that’s it. As their physiotherapist, you are custodian of their record, but you do not “own” that information. It is the client’s health information within that record, and it belongs to the client. They must be able to access their chart record in its entirety upon request. Access rights include both the right to review the chart and the right to a copy of the record.
2.Clients also have a right to review records regarding the disclosure of their health information.
Section 41 of the Health Information Act (HIA) sets out that a Custodian must also track when and to whom health information has been disclosed. If a client wants to know who you have shared their health information with, you must be able to produce it. Health-care organizations must inform clients how they can go about making a request for access to their records. You can a find sample template for a Collection Statement, a chart access request form and other templates around consent, use, storage, etc. In the Health Information Act Policies and Procedures for Alberta Physiotherapist Custodians Guide [LINK]. Clients are legislatively entitled to get copies of their chart records.
When the client provides you with notification they would like a copy of their chart record, you must determine the applicable privacy legislation. For physiotherapists, almost all of your health records will fall under the HIA. See the Privacy Guide for Alberta Physiotherapists (2026) [LINK] for information about when different pieces of privacy legislation apply to health records in your custody and control. The client’s right to access their own personal health information is established in the HIA:
- Health Information Act (HIA) Section 7(1) states that “An individual has a right of access to any record containing health information about the individual that is in the custody or under the control of a custodian.”
Data from the College of Physiotherapists of Alberta is showing that clients can be met with barriers to access copies of their chart records including delays in responding to requests. Subject to the HIA, physiotherapists must make “every reasonable effort to respond within 30 days after receiving the request.” (HIA, Section 12(1)).
3.Fees
One of the barriers that the College often hears about from members of the public are the fees being charged to access chart copies. You must follow the wording in the Health Information Act and the Standards of Practice – Funding Fees and Billing.
HIA: Fees are set at $25 plus $0.25 for every page over 20 pages. This fee is legislated and the $25 covers the work it takes to complete the request. There is no wiggle room, so it is important to recognize this fee structure is applied at all times with any requests for chart copies under the HIA.
For more information on fees for chart records, you can access Sections 9-15 as well as the fee schedule within the Health Information Regulation.
The Standard of Practice – Funding, Fees, and Billing states the following specific expectations around fees for client records to ensure the principles stated above are supported. Establishes fees for access to client records that are:
- Consistent with the requirements of applicable legislation
- Reflect the costs of providing a copy of the client record
- Consistent regardless of the party requesting access
Prior to physiotherapists being Custodians under the HIA there wasn’t a structured fee schedule for chart access. However, with the change to the HIA it is necessary for physiotherapists to charge fees that are consistent with the legislation. It does not matter who is requesting the chart access, whether it is a patient, a lawyer, funder, etc.
The only exception to this is if another Custodian requests disclosure of the chart for the purposes of providing ongoing care. You cannot charge another custodian for the work required to produce the client health information for them. The provisions around access are specific to clients and their authorized representatives. The entire purpose of the HIA is to enable information sharing where custodians have an authorized purpose for accessing information.
4.You are responsible to explain to your client how this works at your practice site, or to refer your client to the person who is responsible to do so.
The Funding Fees and Billing Standard of Practice states that a physiotherapist:
- Makes a reasonable effort to ensure that clients understand the fees and billing practices of the physiotherapist before they become subject to them.
Physiotherapists are expected to know and relay information to their client so they understand how they can access and be provided with a copy of their record. This is often included in your Collection Statement given to each client when they first come to your clinic.
If you work in a larger clinic or multi-clinic organization, you may have a privacy officer that you can direct your clients to if they have questions. Those working in a smaller clinic may be the one responsible to answer any questions or justify any costs.
While in public practice, you should be able to provide your clients with contact information for your medical records departments or other party that handles these requests.
As a physiotherapist you are responsible for any billing under your name so while the administrative staff or privacy officer can handle the details of a chart request, you do need to be aware of the request and what fees are being charged to make sure these are occurring as required in the HIA and Standards of Practice.
5.Fees for chart copies should be transparent and accurate
The Funding Fees and Billing Standard of Practice states that a physiotherapist:
- Prior to the client being subject to any fee, confirms the client or payor has been provided a comprehensive fee schedule that includes transparent and accurate information about billing policies and all potential charges…”
An estimate of the cost to produce the chart record should be provided to the client when they make their request.
Physiotherapists are responsible when their clients request access to their chart record. You must:
- Be aware of fees established in the HIA in relation to client access to health information.
- Be aware of your practice site’s policies and procedures when it comes to a client’s access to their chart records.
- Confirm that those policies and procedures align with the legislative requirements and expectations in the Standards of Practice.
- If the policies do not align then you need to address it with those responsible for setting the policies and procedures at the practice site.
