Patients treated at the Hospital for Special Care may request a copy of their medical records by faxing or mailing the completed, signed Authorization to Release Patient Health Information  form, following the instructions below.
Adobe Acrobat Reader is needed to download and print the form.
Specify what information you want sent from the medical record. Please be as specific as possible. Be sure to include the patient’s:
If copies are going directly to a physician or hospital, there is no charge. If copies of the medical records are to be sent directly to you, there is a fee of 65 cents per page. You will receive a bill from HealthPort for your copies.
Fax or mail to:
For questions, call: 860.827.4863(Monday – Friday, 8 am-4 pm)