The hospital employee's certification of the hospital medical records under section 5 of this chapter must:

1. (1) be signed by the hospital employee with custody of the hospital medical records; and

2. (2) include:

   1. (A) the full name of the patient;
   2. (B) the patient's medical record number;
   3. (C) the number of pages in the hospital medical record; and

   4. (D) a statement in substantially the following form:

      "The copies of records for which this certification is made are true and complete reproductions of the original or microfilmed hospital medical records that are housed in __________ (name of hospital). The original records were made in the regular course of business, and it was the regular course of ____________ (name of hospital) to make the records at or near the time of the matter recorded. This certification is given under IC 34-43-1-5 by the custodian of the records instead of the custodian's personal appearance.".

      [Pre-1998 Recodification Citation: 34-3-15.5-6(c).]

As added by P.L.1-1998, SEC.39.