Open Monday through Friday from 8:00 a.m. to 4:00 p.m.
Telephone: 1-508-957-9831 Fax: 508-696-8708
Your medical record is confidential. It may not be released without your written consent or that of your authorized representative. It contains:
- The information you give the Patient Registration Office.
- Reports of all work performed and all medications you received.
- Documentation from doctors, nurses and allied health professionals.
Ways to get a copy of your medical record:
- Make the request through Patient Gateway
- Download the Authorization for Release of Protected or Privileged Health Information above
- Call the Medical Records Department and we can send you the form.
Please include the following information on the form:
- Your full name at the time of treatment
- Date of birth
- Date(s) of treatment
- The name and address of the person or facility to which disclosure is to be made
- The kind and amount of information to be disclosed; for instance, “a summary of my hospitalization”
- The purpose of the disclosure; for instance, “Continuing Care” or “Insurance”
- Your signature
- Date of consent
- Photo identification will be needed when you pick up your records.
Usually you may expect a response within about two weeks unless your request is medically urgent. For urgent requests please allow 48 hours preparation time.
You may revoke your consent for the release of records at any time, unless the facility had already sent the forms under your consent. You may also specify a time frame for the disclosure. After that time, your consent becomes automatically invalid.
There may be a fee to cover our costs for this service. This fee will be waived if the records are being sent directly to a new physician and/or another healthcare facility.
