You can satisfy the direct-fax rule by having your Quebec doctor send the French originals and having either the covered U.S. clinic or a qualified translator create and transmit the English version.
“I am moving from Quebec to the US and need to transfer my medical records. My records are in French, but US clinics require them in English and insist they be faxed directly from my Canadian doctor. My Canadian clinic won't translate them, and the US clinic won't accept certified translations if I hand them in myself. How do I handle transferring and translating my medical records so US clinics will accept them?”
Summary
Quebec’s physician code lets you name the U.S. clinic or translator as the direct recipient and gives the physician up to 30 days to send pertinent records. You do not need to make the Quebec clinic perform the translation—the source-record and translation jobs can remain separate.
The workable route depends on your English proficiency, the U.S. clinic’s federal-funding status, and exactly who it permits to fax the English version.
If you have and the recipient is a , submit a written language-assistance request after the French originals arrive. The clinic must take reasonable steps to provide meaningful access; when translation is required, it must be free, accurate, timely, private, and performed by a . [45 CFR 92.2(a); 45 CFR 92.201(a)-(b)]
If you are not LEP, the clinic is not covered, or it decides a full translation is not required, authorize your Quebec physician to fax the French source record directly to both the U.S. clinic and your translator. Quebec’s physician code requires the doctor, within 30 days of a written request, to hand pertinent information to any person you designate; the translator—not you—then faxes the English version directly to the U.S. clinic. If the clinic insists that the entire packet come from the doctor, have the translator return the translation to the Quebec doctor for forwarding, but §98 does not compel the doctor to adopt or forward a translator’s work. [Quebec Code of ethics of physicians §98]
Your clinic has expressly rejected this route, and the cited federal rules do not create a general right to override that intake decision. HIPAA applies to covered entities and business associates; it does not itself require a clinic to accept a patient-delivered foreign-record translation or make an ordinary Quebec clinic translate it. [HHS, Covered Entities and Business Associates]
Section 1557 requires reasonable language access, but it does not automatically require a clinic to translate every page of every outside medical record.
Read the full explanationHide the full explanation
Watch out for
Next steps
These steps create a traceable French-source and English-translation packet without asking you to hand-deliver the translation.
Before the move
Write two recipient-specific authorizations
Send a written request to your Quebec physician and, where applicable, the body’s person responsible for protecting information. Use separate signed language for each purpose: “Send my pertinent French medical records for [date range/categories] directly to [U.S. clinic and fax] for continuity of care,” and “Send the same French source documents to [translator and fax] solely for English translation.” State that each authorization ends when that transmission is complete. Quebec’s direct-to-designated-person deadline is no more than 30 days. [R-22.1 §§6, 32; Quebec Code §98]
Requirements
Allow up to 30 days
Have the doctor fax the unchanged French source
Ask the Quebec physician to fax the pertinent French originals directly to the U.S. records department and send you a separate personal copy. For direct third-party transmission, the physician may charge reasonable reproduction or transmission costs, must disclose the approximate amount first, and cannot hold the documents until payment; an approved own-access copy from a body under R-22.1 §66 is free. [Quebec Code §§95, 98; R-22.1 §66]
Requirements
After the source fax
Use the translation branch that applies
If you have and the recipient is a , request translation as language assistance. A covered clinic with at least 15 employees must have a Section 1557 Coordinator; if translation is required, it must be free and use a . Otherwise, authorize your Quebec doctor to send the French source directly to a qualified translator and instruct the translator to fax the English version directly to the U.S. clinic. If the clinic insists the whole English packet come from the doctor, have the translator return it to the Quebec doctor for forwarding; Quebec law does not compel that final forwarding of third-party work, so acceptance remains governed by the clinic’s policy. [45 CFR 92.2, 92.4, 92.7, 92.201; Quebec Code §98]
Requirements
If required assistance is denied
Escalate a covered-clinic refusal
For a covered clinic with at least 15 employees, file a grievance with its Section 1557 Coordinator, who must receive and process grievances. You may also file electronically through the HHS Office for Civil Rights portal at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf. If the clinic is not covered, you are not LEP, or translation is not required for meaningful access, the cited federal rule does not compel acceptance; the remaining concrete option is a different clinic willing to receive the doctor-to-translator packet. [45 CFR 92.7; HHS OCR Civil Rights Complaint Process]
Requirements
Legal sources
The governing sources are Quebec’s health-information statute and physician code, plus current HHS and eCFR Section 1557 rules.
Quebec Act respecting health and social services information, CQLR c R-22.1
Your releases to the U.S. clinic and translator must each be clear, specific, and separately presented.
§6
Any consent to the use or communication of information held by a body must be clear, free and informed and be given for specific purposes. Consent must be requested for each such purpose, in clear and simple language. It is valid only for the time necessary to achieve the purposes for which it was requested. If the request for consent is made in writing, it must be presented separately from any other information communicated to the person concerned.
Quebec Act respecting health and social services information, CQLR c R-22.1
This establishes the written-request process, 30-day response period, and free access-copy rule for Quebec health-information bodies.
§§32, 34, 66
A person wishing to exercise a right provided for in any of Divisions I to IV must submit a written request for access or rectification, as applicable, to the person in charge of the protection of information within the body concerned. The person in charge of the protection of information must respond to a request promptly and not later than 30 days after the date the request is received. A body holding information must, where the person in charge of the protection of information within the body has granted a request for access submitted in accordance with Division V of Chapter III, communicate to the applicant, free of charge, the information concerned and allow the applicant to examine it on the premises during regular working hours or by remote access and to obtain a copy of it.
Quebec Code of ethics of physicians, CQLR c M-9, r 17
A written request can direct a Quebec physician to send pertinent information to the U.S. clinic or translator you name.
§98
A physician must, at the patient’s written request and within not more than 30 days of its receipt, hand over to the physician, employer, establishment, insurer or any other person designated by the patient, pertinent information from the patient’s medical record which is in his possession and safekeeping.
Quebec Code of ethics of physicians, CQLR c M-9, r 17
A physician may recover reasonable copying and transmission costs but must disclose the estimate and cannot hold the records pending payment.
§95
A physician may demand from a patient reasonable fees no greater than the cost of reproducing or transcribing such documents and the cost of transmitting a copy of the latter. A physician who intends to demand such fees must, before proceeding with any reproduction, transcription or transmission, inform his patient of the approximate amount he will be required to pay. Despite the foregoing, a physician may not withhold the documents until payment of the fees by the patient.
45 CFR 92.2
This identifies which U.S. health programs are subject to Section 1557.
§92.2(a)
Except as otherwise provided in this part, this part shall apply to: (1) Every health program or activity, any part of which receives Federal financial assistance, directly or indirectly, from the Department; (2) Every health program or activity administered by the Department; and (3) Every health program or activity administered by a title I entity.
45 CFR 92.201
When the rule requires translation, the covered clinic—not the patient—must provide qualified, free, accurate, and timely assistance.
§92.201(a)-(b)
( a ) General requirement. A covered entity must take reasonable steps to provide meaningful access to each individual with limited English proficiency (including companions with limited English proficiency) eligible to be served or likely to be directly affected by its health programs and activities. ( b ) Language assistance services requirements. Language assistance services required under paragraph (a) of this section must be provided free of charge, be accurate and timely, and protect the privacy and the independent decision-making ability of the individual with limited English proficiency. ( 2 ) When translation services are required under this part, a covered entity must utilize the services of a qualified translator in its health programs and activities.
45 CFR 92.4
This supplies a concrete standard for selecting someone to translate technical medical records.
Definition of “Qualified translator”
Qualified translator means a translator who: (1) Has demonstrated proficiency in writing and understanding both written English and at least one other written non-English language; (2) Is able to translate effectively, accurately, and impartially to and from such language(s) and English, using any necessary specialized vocabulary or terms without changes, omissions, or additions and while preserving the tone, sentiment, and emotional level of the original written statement; and (3) Adheres to generally accepted translator ethics principles, including client confidentiality.
45 CFR 92.7
A covered clinic with at least 15 employees must have a coordinator who handles compliance and grievances.
§92.7(a)
A covered entity that employs fifteen or more persons must designate and authorize at least one employee, a “Section 1557 Coordinator,” to coordinate the covered entity's compliance with its responsibilities under section 1557 and this part in its health programs and activities, including the investigation of any grievance communicated to it alleging noncompliance with section 1557 or this part or alleging any action that would be prohibited by section 1557 or this part.
HHS HIPAA Covered Entities and Business Associates
HIPAA has a defined scope and does not supply a general rule compelling acceptance of patient-delivered translations.
The HIPAA Rules apply to covered entities and business associates. If an entity does not meet the definition of a covered entity or business associate, it does not have to comply with the HIPAA Rules.
HHS OCR Civil Rights Complaint Process
This is the federal escalation channel if a covered clinic denies required language access.
File your complaint electronically via the OCR Complaint Portal.
These are the official rules as published on the cited dates; rules and clinic policies can change.
This is general information about official processes, not legal advice; SettleKit is not a law firm.
Related answers
Join the SettleKit newsletter
We research the hard parts of settling in the US and write articles you will not find anywhere else. Subscribe to get each new article by email.