Patients & Visitors
Request Medical Records
As the COVID-19 situation evolves and for the safety of our patients, patient’s representatives and staff, we encourage downloading the Authorization for Release of Health Information Pursuant To HIPAA form instead of an in person visit to our hospital offices, see below Medical Records Release Forms section.
Physician office or hospital can request records during office hours by faxing a request on a letter head to 914-349-8229 or calling 718-920-4921.
It is the obligation of Montefiore to protect the confidentiality of a patient's medical record. Any information contained in the medical record is confidential and protected by Federal and State law.
Medical record request is generally honored to furnish information to the patient or authorized patient representative, or another party, which may include but not limited to another physician, medical facility, an attorney, court or an insurance company.
Access to Medical Records
Primary care patients can email their doctor, check on lab results, request a medication refill, access information to manage their health and create their own personal health record to access at any time 24/7 through a secure patient portal. Learn more about this online feature.
How to Obtain Copies of Medical Records
Medical records, X-rays or other radiological images can be requested directly from the provider’s office, by mail or in person by visiting the Health Information Management Department at one of the Montefiore Hospitals.
If medical records, X-rays or other radiological images are requested in person, the patient or authorized patient representative must present a form of identification such us a driver’s license or picture ID with signature.
For Healthcare Providers
Physician office or hospital can request records during office hours by faxing a request on a letter head to 914-349-8229 including the following information:
- Patient’s name
- Patients date of birth
- Date of service you are requesting
- Portions of the records you are requesting
- Why you need the records
- When you need records by
Medical Records Release Forms
To request medical records, X-rays or other radiological images by mail, complete an Authorization for Release of Health Information Pursuant To HIPAA form:
It is important following information is provided when completing the form:
- Patient information
- Name and address of the facility releasing the record
- Name and address where the information will be sent
- Dates when care was received- it can be one day or a range of dates and years
- What information is requested, entire or portions of the medical record
- Reason for release
- Date when the release will expire
- Signature and Date
When medical records contain information for one or more of the following categories, indicate this by initaling the appropriate section of the Authorization in addition to completing it in full:
- Alcohol/Drug Treatment
- Mental Health Treatment (except psychotherapy notes)
- HIV/AIDs Related Information
Please mail the completed HIPAA form to:
111 East 210th Street, Bronx, NY 10467
Attention: Health Information Management Department.
In special circumstances, additional supporting documents may be required for release of information.
For questions, please contact 718 920 4921.
Applicable Fees and Delivery Expectations
A fee of $0.75 per page may be charged for paper records or $6.50 for copies of records on a CD. There are no charges when records are sent directly to another physician or medical facility.
In accordance with New York state law, requests will be processed within 10 business days after the authorization is received.
Note: If a person other than the patient is picking up the records, the other person’s name must be indicated in the authorization form and the person must present an identification at the time of pickup.
HIPAA provides the patient with the right to amend his/her record. If you believe the information in your medical record is incorrect, you can request an amendment to your record. The health care provider will review and respond to the request. A request to amend records can be done in person by visiting the Montefiore Health Information Management (HIM) Department. HIM will coordinate the amendment process between the patient and the health care provider.
If you have any further questions, please visit one of our offices or contact 718 920 4921.