Patients treated at Yale New Haven Hospital, Yale New Haven Children's Hospital or Yale New Haven Psychiatric Hospital can request a copy of their medical records by faxing or mailing the appropriate, signed Authorization for Access/Release of Information form per the instructions below.
How to Request Medical Records
For records from Yale New Haven Hospital, Yale New Haven Children's Hospital, Smilow Cancer Hospital, the Saint Raphael Campus and the former Hospital of Saint Raphael, please use the instructions below. 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
- Print the document, then fax or mail to:
Yale New Haven Hospital
Medical Record Department
Medical Information Unit
PO Box 9565
New Haven, CT 06535
- For questions, call 203-688-2231
To request copies of X-rays or other radiological images
Please call 203-688-6054.
Fax completed forms to 203-200-5101.
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:
- When Completing Request Form
- Date of birth
- Current address
- Current phone number
- Dates of service
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.