Patients & Families
It is the obligation of the hospital to protect the confidentiality of our patients’ medical records. Any information contained in the medical record is confidential and protected by federal and state law. Therefore, patient information will only be released upon receipt of appropriate patient authorization, valid subpoena or court order.
Patients must complete the Authorization for Release of Protected Health Information form (available in English or Spanish) in order to obtain a copy of their medical records. For patients who are younger than 18, parents, next of kin or legally appointed guardians must complete the form in order to obtain a copy of medical records. When a minor has received treatment for sexually transmitted disease, birth control, drug/alcohol abuse, HIV or mental illness, the records will only be released upon the minor’s authorization.
A qualified person or personal representative may obtain the records of a deceased patient upon receipt of a notarized, written request, or a completed Authorization for Release of Protected Health Information form and letter of testamentary or a letter of administration from a Surrogates Court. Questions regarding the release of deceased patient records in the absence of these documents should be referred to the manager of the Health Information Management department.
How to Submit Requests for Medical Records
Fax the completed Authorization for Release of Protected Health Information form to 860.837.5785 or send it by mail to:
Connecticut Children’s Medical Center
Connecticut Children’s Specialty Group
Health Information Management Department
Attn: Release of Information
10 Columbus Boulevard, 4th Floor
Hartford, CT 06106
NOTE: Please complete all sections of the release form. Incomplete forms will not be processed.
All inquiries regarding requests for access or release of protected health information should be directed to the Health Information Management department by calling 860.837.5780.
Connecticut Children’s staff is here to help referring providers obtain medical records regarding their patients for whom we have provided care. Safeguarding patient information is our priority. We limit the faxing of medical records to urgent circumstances only, and in some cases, signed disclosure authorization is required before we can provide the requested medical information.
To request information regarding your patients for whom Connecticut Children’s has provided care, please contact the specialty department directly. A disclosure authorization form is not necessary.
Patient or Family Requests
If your patients or their parents would like a personal copy of their medical records, they will need to complete and return our Authorization to Disclose Protected Health Information form (available in English or Spanish).
Inquiries regarding requests for access or release of protected health information should be directed to the Health Information Management department by calling 860.837.5780.