You may request a copy of your personal medical records by submitting the completed Authorization to Use & Disclose Health Information form to the Medical Records department. To return the completed form to Medical Records, you may choose one of the following:
- Mail: Frisbie Memorial Hospital, Medical Records Department, 11 Whitehall Road, Rochester, NH 03867
- Fax: To Medical Records at (603) 332-2699 or (603) 994-7419
- In Person: Medical Records is open Monday – Friday from 8:00 am to 4:30 pm.
- Call: Medical Records at (603) 335-8414. If we are unavailable, please leave a message detailing your request.
When submitting your request, you will need to provide the following information:
- Full legal name
- Date of birth
- Social Security number
- Telephone number
- Mailing address
- The type of information (i.e. most recent history and physical, most recent discharge summary, etc.) along with the specific date of that hospital visit
Please allow up to 10 business days to process your request for your personal medical records. You may request that your records be mailed to your address that we have on file. If you request to have your medical records mailed to an address other than the one we have on file, we request that you bring documentation, or photo ID, with your new address information. You will be required also to sign a release form. If you choose to pick up your personal medical records, you will need to present a photo ID. If you need to pick up your medical records on the same day of your request, we ask that you call in advance so that we can accommodate your request. There is no fee to receive a copy of your medical records.
If someone is picking up medical records on your behalf, or if you wish to obtain a copy of a medical record other than your own (patient is under 18 years of age and you are the parent/legal guardian, or if patient is an adult and you have been appointed as legal representative), you will need to complete the Authorization to Use & Disclose Health Information form. You may mail the completed form to the Medical Records department’s address listed above, or by faxing it to (603) 332-2699 or (603) 994-7419.
Information the Medical Records department does not provide:
- Records from your physician’s office. Call his/her office directly
- Images of your radiology exams. Call (603) 335-8400 to request a CD.
- Birth/death certificates. If you were born in Rochester, please contact the Rochester City Clerk’s office at (603) 332-2130 or order online.
- Medical information over the telephone or by e-mail