New Milford Hospital

21 Elm Street
New Milford, CT 06776
Phone 860.355.2611
info@newmilfordhospital.org
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Medical Records

The health information management department is responsible for coordinating release of copies of your medical record. The department is open Monday through Friday, 8:00 a.m. - 4:00 p.m.

Information shown or contained in a patient's medical record shall be treated as confidential and will be released in appropriate circumstances only with proper authorization from the patient or a legal guardian.

Click here to download and print out Medical Records Request Form.The attached "Authorization to Release Information" form should be printed out and completed by the patient whose records are being requested. If the patient is under the age of 18, the legal parent or guardian must sign the authorization. If the patient cannot sign the authorization, a copy of the Power of Attorney or other legal papers must accompany the signed authorization.

Please complete all information on the form, making sure to fill out the date of requested information. Please be sure to sign and date the authorization form. If you have a question, please call 860-350-7259, ext. 4263.

A fee of $.65 per page is charged. If copies are going directly to a physician or hospital, there is no charge.

Completed authorizations should be mailed to:
    Release of Information Coordinator
    Health Information Management Department
    New Milford Hospital
    21 Elm Street
    New Milford, CT 06776



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