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How to Request Medical Records 

To request medical records from Orange Regional Medical Center, you will need to submit a written request to the Health Information Management (HIM) Department.

Orange Regional has achieved the Stage 7 Level designation from the Healthcare Information and Management Systems Society (HIMSS) for implementing technology solutions (EPIC) that have the ability to improve patient safety and quality of care.

You can either use an Authorization for Release of Protected Health Information (PHI) form or you may submit a letter to the HIM Depart ment. (See Writing a Letter to Request Medical Records below). 

Writing a Letter to Request Medical Records

To request medical records from Orange Regional Medical Center, you will need to submit a written request to the Health Information Management (HIM) Department. This letter must include the following information:

    • Identifying information (your name, date of birth, medical record number (if known)
    • The name and address of the individual or institution you wish to receive your records
    • The specific information you would like released; you must also include a time frame (example: April 12, 2006 or April 2006 to May 2006) and the type of information (example: Emergency Room Record)
    • Signature of the patient or legal guardian and date (Please note: if you are submitting a request on behalf of an adult for whom you are the executor or the power of attorney, you must submit a copy of the appropriate documentation)
    • An expiration date for the request. If no date is given, the authorization will expire 1 year after being signed
    • A statement that the authorization may be revoked at any time, except to the extent that action has already been taken in reliance on the authorization
    • Address your letter to location at which you received care (see mailing addresses below)

    Medical record requests are usually processed within seven to ten business days.

    A photo ID is required when picking up requested information.

    • An HIM employee is available in Booth 7 of the Registration area to help you with any questions that you may have. Hours are Monday – Friday, 9am to 5pm.

    Fees

    There is no charge to obtain a copy of your medical record.

    MyChart

    If you have a MyChart account, your records can be released to MyChart. Please make sure to state this on your request.

    If you do not have a MyChart account and would like to sign up for this, please download the MyChart Activation Form and return it to the address below.

    Mailing Addresses

    Orange Regional Medical Center 
    Health Information Management Department
    707 East Main Street
    Middletown, NY 10940

    phone:  845-333-1600
    fax:      845-333-1560

    Download the Authorization for Release of Protected Health Information Form(PDF)

    Orange Regional
    Medical Center

    707 East Main Street
    Middletown, NY 10940
    845-333-1000
    Directions »

    Orange Regional Medical
    Group - Middletown

    707 East Main Street
    Middletown, NY 10940
    845-333-7575

    Orange Regional Medical
    Group - Monroe

    475 Route 17M
    Monroe, NY 10950
    845-333-7830

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    Joint Commission National Quality Approved
    A member of the Greater Hudson Valley Health System