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.