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Medical Records

Release of Information

Patients have the right to:

  • Access or inspect their health record
  • Obtain a copy from their healthcare provider 鈥 reasonable fees may be charged for copying

Records are released in accordance to HIPAA, New York State and federal laws.

Medical record requests are processed within 30 days and may incur a charge. There is no charge for medical record requests for continuity of care that are sent to another provider, nor is there a charge to have records uploaded to a patient鈥檚 .

To receive copies of your or your children's records, you must first sign a release of information giving us permission to release the records. Once 18, a person must sign for his or her own records.

Patients Requesting Their Medical Records

Please complete the Patient Access form on the ROI Forms page. You may also mail or fax a simple letter that includes:

  • Your name and date of birth
  • Which records you are requesting
  • Where to send the records (name, address, and phone number)
  • Your contact information should we have a question about the request (your phone number and address)
  • Sign and date the letter

Non-Patients Requesting Medical Records

Please complete the SH48 form or an OCA 960 form and mail or fax to the contact listed on the form.

Checking Status of a Request

If it has been at least 10 days since you requested records through Release of Information, please contact our Copy Service, Verisma, at 1-866-390-7404.