Request Medical Records
It is the obligation of Montefiore Einstein 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 records requests are generally granted to the patient, an authorized patient representative, or another party, which may include, but not be limited to, another physician, medical facility, attorney, court or insurance company.
What to Know
You can request copies of your medical records as well as radiological and diagnostic images like X-rays directly in your provider’s office, by mail or in person. Requests for medical records can be made by you, an authorized representative or approved parties, including:
- Physicians or medical facilities
- Attorneys or courts
- Insurance companies
Patients who see primary care and specialist providers 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 Montefiore MyChart, a secure online patient portal. Learn more about Montefiore MyChart.
Medical records along with radiological and diagnostic images can be requested in person through your provider’s office or by visiting the Health Information Management (HIM) Department locations at any of our hospitals. Please note that you or your authorized representative must present a valid form of identification.
To request your medical records or radiological/diagnostic images by mail, complete the authorization for release of health information form pursuant to HIPAA below:
When filling out your form, please make sure to provide the following information:
- 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 (a single day or a range of dates and years)
- Information you are requesting (a record in its entirety or portions of it)
- Reason for release
- Date the release expires
- Signature and date
Note: If a person other than the patient is picking up the records, that person’s name must be indicated in the authorization form and they must present an identification at the time of pickup.
When medical records contain information about one or more of the following categories, complete the form in full and initialize the corresponding section:
- Alcohol or drug treatment
- Mental health treatment (except psychotherapy notes)
- Information related to HIV/AIDS
Mail the completed form to:
Montefiore Einstein
Attention: Health Information Management Department
111 East 210th Street
Bronx, NY 10467
Special circumstances may require additional supporting documents for release of information. For questions, please contact 718-920-4921
Healthcare providers can request medical records during office hours by faxing a request on letterhead to 914-349-8229. Please include:
- Patient’s name
- Patient’s date of birth
- Date of service you are requesting
- Portion of medical record you are requesting
- Reason for request
- Date by which you need the records
Applicable Fees & Delivery Expectations
A fee of $0.75 per page may be charged for paper records or $6.50 for digital copies of records on a disc. There is no charge for records sent directly to another healthcare provider or medical facility. In accordance with New York State law, requests are processed within ten days after the authorization is received.
Amendments
HIPAA provides you the right to amend your medical record. If you believe the information in your record is incorrect, you can request an amendment. A healthcare provider will review and respond to your request. A request to amend records can be filed in person by visiting one of our Montefiore Health Information Management (HIM) locations, where a member of our team can coordinate the amendment process.
Montefiore Health Information Management (HIM) Locations
Health Information Management
Jack D. Weiler Hospital (Einstein Campus)
1825 Eastchester Road, Second Floor, Room 2 South-01
Bronx, NY 10461
Monday – Friday: 8:30 AM – 5:00 PM
Health Information Management
Montefiore Wakefield Hospital (Wakefield Campus)
600 East 233rd Street, First Floor (Ask security for directions)
Bronx, NY, 10466
Monday – Friday: 8:30 AM – 5:00 PM
Health Information Management
Westchester Square Campus
2475 St. Raymonds Avenue, Second Floor, Room 2-9
Bronx, NY 10461
Monday – Friday: 8:30 AM – 5:00 PM
Health Information Management
Moses Campus and Children’s Hospital at Montefiore Einstein (CHAM)
3411 Wayne Avenue, Sixth Floor (Ask security for directions)
Bronx, NY 10467
Monday – Friday: 8:30 AM – 5:00 PM
Health Information Management
Montefiore Hutchinson Campus
1250 Waters Place, Main Lobby
Bronx, NY 10461
Monday – Friday: 8:30 AM – 5:00 PM
Hours of operation are Monday – Friday: 8:30 AM – 5:00 PM
If you have any further questions, please visit one of our offices or contact 718-920-4921.