Medical Records and Other Forms

Patients treated at Yale New Haven Psychiatric Hospital can request a copy of their medical records by submitting a signed Authorization for Access/Release of Information form.

Requests for Medical Records

If copies of your medical records are to be sent directly to you, there is a fee of 65 cents per page. If copies are going directly to a physician or hospital, there is no charge.

Please download the following pdf form (you will need Adobe Acrobat Reader installed in order to read the pdf files that contain the forms):

Authorization for Access/Release of Information.
  • 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

YNHPH Medical Records Department can be reached at (203) 688-9933.

Living Wills and Healthcare Proxies

Living wills and healthcare proxies are legal documents that describe your wishes about the type of medical care you would want to receive if you were unable to make those decisions for yourself. They also allow you to appoint someone you trust to make medical decisions for you. It is always a good idea to discuss your wishes or concerns with your family and physician prior to your hospitalization. For additional information and forms, please call the Yale New Haven Hospital Admissions Office at (203) 688-2221.