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Health Information (Medical Records)
HOW TO REQUEST MEDICAL RECORD INFORMATION

The Health Insurance Portability and Accountability Act (HIPAA) requires that we provide information about our privacy practices related to your personally identifiable information. At the time of admission each patient is provided a written copy of our Privacy Notice. Click here to review the current DHHS Privacy Notice.

What are the hours that I may contact Health Information if I have a question about requesting medical records?
Monday – Friday, excluding State holidays, from 8 AM to 4:00 PM
What is the mailing address for Health Information?
New Hampshire Hospital
Health Information Department
36 Clinton Street
Concord, NH 03301

What is the phone and fax number?
Our phone number (603) 271-5522
Our fax number (603) 271-5784

Is there an e-mail address where I can contact Health Information about my request?
Yes, you can e-mail us at MedicalRecordRequests@dhhs.state.nh.us

How do I obtain an Authorization to Disclose Protected Health Information form?
Complete the authorization form Adobe Acrobat Reader Symbol You may also contact us at the above phone number and we will mail or fax one to you or you may pick one up in the Hospital lobby Information Center. We can also send you a form by e-mail Once you have completed, signed and dated the form you may mail, fax or e-mail it to our office using the address, fax or e-mail information listed above.

Can I obtain a copy of medical records other than my own?
Generally, no, but there are some exceptions. You will need to bring written documentation if:

  • You have written authorization from the patient;
  • You are the patient’s legal guardian;
  • You are the court appointed legal representative for the patient;
  • The patient is under 18 and you are the parent or legal guardian;
  • The patient is deceased and you are the administrator of the estate,
  • The patient is deceased, has no estate administrator and you are the current surviving spouse.

I called to request copies of my medical record for my personal use and was told that I had to make the request in writing. Why wasn’t my phone call good enough?
Your privacy is important to us. Your written request is another way to ensure that you are the person who has requested the information and that it will be sent to you at the correct address.

How do I request copies of my medical records for personal use?
You may send us a letter requesting the copies. Please include your name, date of birth, any other names you may have used (such as maiden name or other married names). Please be specific with the dates of information and reports you wish disclosed and be sure to sign and date the letter. There may be a fee for this service.

I called to request copies of my medical record for my new care provider and was told I needed to sign an authorization to disclose the information. Why wasn’t my phone call good enough?
We must comply with Federal and State regulations that protect the privacy of your health information. It is unlawful to disclose information without your written authorization. There are certain records protected by special laws. Psychiatric records, substance abuse records or records that indicate HIV status require specific authorization from you.

How do I request copies of my records for my non-New Hampshire Hospital physician or other care provider?

  • If you were recently admitted to the hospital and signed an authorization to send information to your care providers, we will send the information once the record is complete.
  • If you were admitted longer than a year ago or if you have other providers to whom you wish to send copies of your record, please complete the New Hampshire Hospital Authorization to Disclose Protected Health Information and return it to the Health Information Department.

Can I obtain copies of a deceased family member’s medical record?
If you are the administrator of the estate you may have copies. If the records are of your spouse and your spouse had no will, you may have access to the records, otherwise the administrator of the estate must authorize the disclosure to you. Please contact the Health Information Department (271-5522) to discuss the additional documentation we will require from you to obtain a deceased family member’s medical record.

I’m developing my family’s genealogy; can I obtain copies of my deceased family member’s medical record?
Requests for genealogy information should be directed to NH Vital Records Genealogy Vault (603) 271-4650

What if I change my mind about disclosing the information after I send the Authorization to Disclose Protected Health Information to New Hampshire Hospital?
Call us and let us know that you want to cancel the request. We will hold the request until we receive a written statement from you that you wish to withdraw the request. Upon receipt we will be able to stop any further disclosure. We are unable to retrieve the information sent prior to your written revocation based on your signed authorization.

How much information do you send for each request?
We limit the information sent to the minimum necessary for the purpose stated on the request. You must specify on the authorization form the specific information to be disclosed.

What happens to my information after it is disclosed?
You should ask the receiver of your information how it is used and stored.

I was a student while at New Hampshire Hospital’s Anna Philbrook Center, how do I get transcripts of my grades?
The education program at the Anna Philbrook Center closed July 1, 2010. We are required by NH State law to retain education records for a period of 6 (six) years, however we are required by State law to keep transcripts of grades permanently. Follow the same process to request medical records. Separate Federal guidelines govern the disclosure of education records. You will be asked to sign a special authorization for disclosure of education records.

How do I obtain the special authorization form to disclose my education records?
Contact the Health Information Department (603) 271-5522. You can also send us an e-mail at MedicalRecordRequests@dhhs.state.nh.us or complete the authorization. Adobe Acrobat Reader Symbol

My child was a patient at New Hampshire Hospital before their 18th birthday, but is now 18 years old. I was told my child would have to authorize disclosure of the medical records. Why can’t I authorize the disclosure?
Once your child becomes 18 years old and you are no longer their legal guardian, your child is considered an adult. He or she must authorize the disclosure of the information regardless of their age when a patient at New Hampshire Hospital.

Once you have received my written authorization to disclose my records how long does it take for you to mail them?
We make every effort to send the information within 10-12 working days. If you have an upcoming appointment with your care provider, please let us know the date and we will make every attempt to have the records arrive in time for your appointment. If you were recently discharged it may take longer to comply with the request since we need to make sure all the information in your record has been completed before sending it. It may take up to 15-20 working days after your discharge date.

What if I have followed your procedures and I still have a question?
Please call us at (603) 271-5522 or e-mail at MedicalRecordRequests@dhhs.state.nh.us Our customer service staff can assist you.

 
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New Hampshire Department of Health and Human Services
129 Pleasant Street | Concord, NH | 03301-3852


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