Complete the online patient authorization for release of information.
- Fill out form in English >
- Fill out form in Spanish >
- Download form in English >
- Download form in Spanish >
How can I request my hospital medical records to be sent to my doctor, myself or my personal representative?
You can request medical records in several ways:
- Complete the online patient authorization form for release of information.
- Mail, fax, scan or email your completed authorization form to the hospital’s address.
- You can also stop by the hospital in person with your completed authorization form.
How can I request my hospital medical records be sent to my insurance, attorney, school or work?
You can request medical records in several ways:
- Complete the online patient authorization form for release of information.
- Mail, fax or email your completed authorization form to Atlantic Health System Release of Information, located at our Southgate Parkway location.
Can someone else pick up my medical records?
Yes, as long as you provide a written request. The designee must present a valid driver’s license, passport or county identification at the time of pick up.
Is there a cost for copies of my medical records?
In most cases, patients or their personal representative may request medical records at no charge, but some exceptions apply:
- Medical records sent directly to a physician’s office or other health care facility are always free
- Medical records released to a patient’s MyChart patient portal are free
- Medical records maintained electronically are free for the first copy; subsequent copies cost $6.50
- Medical records maintained on paper incur a $6.50 fee
When can I expect to receive a copy of my medical records?
Atlantic Health System will make every effort to prepare your medical records in a timely manner, but by law, we are allowed up to 30 days should any extenuating circumstances arise. Please allow for this processing time when making your request; we will advise you of the estimated completion date.