Medical Records

The Health Information Management Department (Medical records) maintains and safeguards the confidentiality of medical record information in accordance with the patient’s right to privacy, legal requirements and appropriate ethical considerations.

Requests for Medical Records Copies

The medical record and its contents are the property of the Hartford HealthCare, however, patients and/or their authorized representative are entitled receive copies of the information contained.

Depending on the purpose of the request there may be a fee associated with the copy costs in accordance with Connecticut Regulations. No cash will be accepted for payment of copies. The Health Information Management Department can contact you to pick up your records with a valid photo ID, records can be mailed to you or released to the MyChartPlus Patient Portal.

Patient and patient representative requests will be responded to within 15 business days according to the 21st Century Cures Act, in the form and format requested by the patient.

Release of Information forms

• Authorization to Disclose/Obtain Health Information (English)
• Authorization to Disclose/Obtain Health Information (Spanish)
• Request to Amend Protected Health Information (English)
• Request to Amend Protected Health Information (Spanish)
• MyChart Proxy Access to Adult Medical Record
• MyChartPlus Access Authorization with Minor Proxy

How do I obtain a copy of my medical record?

1. We require a written request to serve as documented proof of your request for medical records. To protect your privacy, please download and complete our Hartford HealthCare Authorization above. Copies of appropriate identification and documentation must accompany patient request and legal representative request.

2. Mail, Fax, Drop-off, Email the form to the following locations:

How do I obtain a copy of my Radiology (X-ray) films?

We require a written request for radiology films and images. To protect your privacy, please download and complete our Hartford HealthCare Authorization above. Copies of appropriate identification and documentation must accompany patient request and legal representative request. You may forward your request for radiology films to each Hospital’s Radiology Department. Depending on the purpose of the request, there may be a fee associated with the copy costs.

Birth/Death Certificates

Refer to the respective town or city website for further details.

Birth and Death Certificates may be obtained in person, through a mailed-in request, or online through VitalChek. Note that in accordance with State of Connecticut Statutes, birth certificates are legally available to:

• The person him/herself sixteen years of age or older
• A parent, spouse, grandparent or child of said person
• A legal representative or legal guardian with appropriate proof of legal status

Amendment Request

HIPAA privacy rule provides individuals with the right to request an amendment of their Protected Health Information (PHI) within the designated record set. [45 CFR §164.526 (a)(1)]. Request for amendment must be submitted in writing using the Request to Amend Protected Health Information form and can be sent to various Health Information Management Departments listed on the form or emailed to Amendments@hhchealth.org.

The responsible provider will review your request and may either agree or disagree with your request. If the amendment is agreed to, your original request and the amendment will be made a part of your medical record. If the provider disagrees with your request, the statement of disagreement and your original request will be made a part of your medical record. Any future disclosures will include the amended information and/or your request to amend the information upon your request. It is unlawful to remove any portion of your medical record. For that reason, any changes made will be in the form of an addendum.

The facility has 60 days to respond to this request unless notification is provided of the need for a 30-day extension.