Complete the online patient authorization for release of information.
- Fill out form in English >
- Fill out form in Spanish >
- Download form in English >
- Download form in Spanish >
How can I request my hospital medical records to be sent to my doctor, myself or my personal representative?
You can request medical records in several ways:
- Complete the online patient authorization form for release of information.
- Mail, fax, scan or email your completed authorization form to the hospital’s address.
- You can also stop by the hospital in person with your completed authorization form.
How can I request my hospital medical records be sent to my insurance, attorney, school or work?
You can request medical records in several ways:
- Complete the online patient authorization form for release of information.
- Mail, fax or email your completed authorization form to Atlantic Health System Release of Information, located at our Southgate Parkway location.
Yes, as long as you provide a written request. The designee must present a valid driver’s license, passport or county identification at the time of pick up.
Is there a cost for copies of my medical records?
In most cases, patients or their personal representative may request medical records at no charge, but some exceptions apply:
- Medical records sent directly to a physician’s office or other health care facility are always free
- Medical records released to a patient’s MyChart patient portal are free
- Medical records maintained electronically are free for the first copy; subsequent copies cost $6.50
- Medical records maintained on paper incur a $6.50 fee
When can I expect to receive a copy of my medical records?
Atlantic Health System will make every effort to prepare your medical records in a timely manner, but by law, we are allowed up to 30 days should any extenuating circumstances arise. Please allow for this processing time when making your request; we will advise you of the estimated completion date.