Requesting Medical Records

Patients of Northeast Medical Group may request their medical records by following these instructions. You will need Abode Acrobat Reader installed to download the form.

  • Dowload this interactive PDF, complete it and save the document:

    YNHHS Authorization for Access/Release of Document pdf

  • Print the document, then fax or mail to:
    203-688-4645
    Yale New Haven Hospital
    Medical Record Department
    Medical Information Unit
    PO Box 9565
    New Haven, CT 06535

  • For questions, call 203-688-2231

When Completing Request Form

Specify what information you want sent from your medical record. Please be as specific as possible. Be sure to include your/the patient's:

  • Date of birth
  • Current address
  • Current phone number
  • Dates of service