Requesting a Copy of Your Personal Medical Record
To request a copy of your personal medical record, please complete the Authorization to Use & Disclose Health Information form and submit to Frisbie’s Medical Records office, one of three ways:
- By Mail: Frisbie Memorial Hospital, Medical Records Department, 11 Whitehall Road, Rochester, NH 03867
- By Fax: To Medical Records at (603) 332-2699 or (603) 994-7419
- In Person: Medical Records during regular business hours, Monday – Friday from 8:00 am to 4:30 pm.
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 the request for your personal medical record. You may request that your medical record be mailed to your address we have on file. If you request to have your medical record mailed to an address other than the one we have on file, we will require documentation, or photo ID, with the updated address information. You will be required also to sign a release form. If you choose to pick up your personal medical record, you will need to present a photo ID. If you need to pick up your medical record 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 record.
If someone will be picking up your medical record 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 and submit to Frisbie’s Medical Records office.
Information the Medical Records department does not provide:
- Records from your physician’s office can be obtained by contacting the office directly
- Images of your radiology exams can be obtained by calling (603) 335-8400
- If you were born in Rochester, you may obtain your birth certificate by contacting the Rochester City Clerk’s office at (603) 332-2130.
- Medical information over the telephone or by e-mail
Frisbie Memorial Hospital Medical Records Department
11 Whitehall Road
Rochester, NH 03867
Monday - Friday from 8:00 am to 4:30 pm.