Medical Records Request
Patients may request copies of their Huggins Hospital medical records by contacting our Health Information Management Department (603) 569-7541 or by e-mail at email@example.com.
In order to request a copy of Your Medical Records:
Print and complete a Request for Medical Records form.
In completing the request form:
Indicate the dates of treatment for which you are requesting information. This is particularly important for individuals that have had multiple episodes of care at Huggins Hospital.
- Indicate the purpose for the disclosure.
- Indicate the format of how you would like to receive the information (paper, electronic data storage device or e-mail).
- Indicate the type of records needed.
- Indicate if a personal representative will be picking up the records for you.
- Review sections 6 & 7.
- Sign and date.
Submitting a Request
Once the Request Form has been completed, the request can be submitted by one of the three following methods:
1. Bring form in-person to the Health Information Management (HIM) office. The staff at the Information Desk in the Huggins Hospital Main Lobby can give you directions. Hours are Monday through Friday, 7 AM to 5 PM, except holidays.
2. Mail form to:
Health Information Management Office
240 South Main Street
Wolfeboro, NH 03894
3. Fax form to: 603.569.7542 Attn: Release of Information.
4. Attach the request to an email and send it to: firstname.lastname@example.org