Wentworth-Douglass Hospital
(603) 742-5252
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Medical Records

Patients or their personal representative may inspect or obtain copies of their Wentworth-Douglass Hospital medical records or have copies sent to another facility by following the instructions below:

  • When possible, please give our Medical Information department a 48-hour notice prior to picking up information.
  • Have an idea of what information you need and the date of service (ex: a Nuclear Medicine study done on 1/25/2010).
  • You must have two forms of identification before leaving with any medical information. This can include a drivers license, picture ID and another ID with a signature such as a credit card, library card or Social Security card.
  • If you are picking up information for another person, you must also have two forms of identification and a written note from the patient requesting information, making note of the person's name who is picking up the information. The patient requesting the information must sign the note.
  • A release of information form must be filled out by every individual requesting medical information.
  • Legal Handwritten Signature Accepted Only.

Call (603) 740-2591 to request medical records or for more information.

Hours:  Monday through Friday, 8:00 AM - 4:00 PM

Protected Health Information release form (required for all requests)

Fax your release forms to (603) 740-2290.

 

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Address

Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100