How to Request Medical Records
You will need Abode Acrobat Reader installed to download the following forms.
Yale-New Haven Hospital
Complete this Authorization for Access/Release of Information form.
| Then, fax or mail to: |
203.688.4645
Yale-New Haven Hospital
Medical Record Department
Medical Information Unit
20 York Street
New Haven, CT 06504
|
| For questions, call: |
203.688.2231 |
Yale-New Haven Children's Hospital
Complete this Authorization for Access/Release of Information form.
| Then, fax or mail to: |
203.688.4645
Yale-New Haven Hospital
Medical Record Department
Medical Information Unit
20 York Street
New Haven, CT 06504 |
| For questions, call: |
203.688.2231 |
Yale-New Haven Psychiatric Hospital
Complete this Authorization for Access/Release of Information form.
| Then, fax or mail to: |
203.688.9941
Yale-New Haven Psychiatric Hospital
Medical Record Department - LV3
Medical Information Unit
184 Liberty Street
New Haven, CT 06504 |
| For questions, call: |
203.688.9933 |
When Completing Request Forms
Specify what information you want sent from your medical record. Please be as specific as possible. Be sure to include your/the patient's:
- Full name
- Date of birth
- Current address
- Current phone number
- Dates of service
Applicable Fees
If copies are going directly to a physician or hospital, there is no charge. If copies of your medical records are to be sent directly to you, there is a fee of 65 cents per page.