Medical Records
Your medical records are considered protected health information (PHI). We cannot share your PHI without your consent. These records may include blood test results, medical imaging, doctors’ notes, diagnoses, recommended treatments and prescriptions, and daily chart information. We can help you access them in two ways:
- For your personal use, you can get some records through Mount Sinai South Nassau's patient portal, FollowMyHealth. If you are signed up for FollowMyHealth, you can also collect your medical records from all providers’ electronic record portals through MyLinks or Apple Health. These are tools that keep all your online medical records in one location.
- For other records, you can order paper copies or a CD. Please download the charge sheet for pricing.
Steps to Getting Your Medical Records
There are several steps to obtaining your medical records:
- Complete the appropriate information release form. You can download forms here:
- Patient Access Request for Medical Information in English or Spanish.
- Patient Authorization for Release of Medical Information to Third Party in English or Spanish.
Make sure to include the following information:
- Patient name, address, date of birth, last four digits of the patient's Social Security number, and phone number
- Admission/treatment date
- What information can be released
- Address and the name of the individual or organization to receive the information
- Patient signature
- Submit the form. There are several ways to do this:
- Fax the form to 516-470-6031.
- Email the form to medicalrecordrequests@mountsinai.org.
- Pick the records up in person. Bring your photo ID and the completed form in person, or mail the form and a copy of your ID to the attention of the Correspondence Department:
- For medical records from the emergency room, or for inpatient or ambulatory surgery, visit Mount Sinai South Nassau’s Health Information Management Correspondence Department, open weekdays from 9 am-5 pm.
- For medical records from outpatient care or from one of our off-site facilities, contact the facility where you received care.
- We handle requests from attorneys, insurance companies, private physician offices, and any other non-patient care requests during the Health Information Management business office hours.
- All requests go through the Clinical Data Exchange Department. Please allow 7-10 business days for processing, which is the timeframe approved by state law.
Who Is Authorized to Request Medical Records?
The following people are authorized to request medical records:
- Any adult age 18 or over, or an emancipated minor
- Qualified persons of a deceased patient. This means:
- If you are the appointed administrator or executor, bring a certified copy of the administrator estate paper.
- If there is no appointed administrator or executor, a spouse or close relative can qualify, by bringing a certified copy of the patient's death certificate as well as the signed confirmation of the distributee status form. You may also need to prove your relationship to the deceased.
- An attorney or an individual who holds power of attorney. Bring a copy of the power-of-attorney form that specifically authorizes the individual to make a written request for patient information.
- For a deceased patient, the distributee's (or heir’s) attorney. The person making the request must provide a certified copy of the death certificate, as well as a copy of the power of attorney specifically authorizing the person to make a written request for patient information.
To File a Voluntary Acknowledgment of Paternity
A voluntary Acknowledgment of Paternity is a legal document that both parents sign, if they choose to. It names the father of the baby when the parents are not married to each other. The Acknowledgment of Paternity form must be completed at the hospital.
Before signing, please review the information from the New York State Department of Health, called "Notice Regarding Your Legal Rights and the Consequences of Signing an Acknowledgment of Paternity." You can download a PDF in English or in Spanish.
If you have any questions about this document, contact the Child Support Collection Unit of your county's Department of Social Services. If you have questions regarding the form as it relates to the birth certificate process, contact the local birth registrar where the acknowledgment will be filed.