How do I obtain a copy of my medical record?
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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.
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Mail, Fax, Drop-off, Email the form to the following locations:
Backus Hospital Phone: 860.823.6382 Fax: 860.892.2723 Email: Click here Location: 326 Washington Street Norwich, CT 06360 Hours: Monday – Friday, 8am-4pm
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Charlotte Hungerford Hospital Phone: 860.496.6670 Fax: 860.496.6633 Email: Click here Location: 540 Litchfield Street Torrington, CT 06790 Hours: Monday – Friday, 8am-4pm
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Hartford Healthcare at Home Phone: 860.696.6019 Fax: 860.380.1730 Email: Click here Location: 181 Patricia Genova Dr. HIM Department, 3rd Floor Newington, CT 06111 Hours: Monday – Friday, 8am-4pm |
Hartford Hospital / Institute of Living Phone: 860.972.4764 Fax: 860.545.2328 Healthcare Requests Fax: 860.545.6764 Email: Click here Location: 80 Seymour Street, Bliss 104 Hartford, CT 06102 Hours: Monday – Friday, 8am-4pm |
The Hospital of Central Connecticut Phone: 860.224.5686 Fax: 860.224.5920 Email: Click here Location: 100 Grand Street New Britain, CT 06052 Hours: Monday – Friday, 8am-4pm
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Midstate Medical Center Phone: 203.694.8380 Fax: 203.694.7605 Email: Click here Location: 435 Lewis Avenue Meriden, CT 06451 Hours: Monday – Friday, 8am-4pm |
Natchaug Hospital Phone: 860.456.1311 ext 69965 Fax: 860.456.1381 Email: Click here Location: 189 Storrs Road Mansfield Center, CT 06250 Hours: Monday – Friday, 8am-4pm |
Rushford Phone: 860.852.1049 Fax: 860.346.9038 Email: Click here Location: 1250 Silver Street Middletown, CT 06457 Hours: Monday – Friday, 8am-4pm |
St. Vincent’s Medical Center Phone: 203.576.5193 Fax: 203.581.6556 Healthcare Requests Fax: 203.576.5314 Email: Click here Location: 2800 Main Street, Main Level Bridgeport, CT 06606 Hours: Monday – Friday, 8am-4pm |
Windham Hospital Phone: 860.456.6743 Fax: 860.456.6885 Email: Click here Location: 112 Mansfield Avenue Willimantic, CT 06226 Hours: Monday – Friday, 8am-4pm |
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 [email protected].
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.