ALL patients are seen at our Portsmouth office on Saturday and Sunday for sick visits from 9-12 am

Offices:

Hampton

603.929.3838

55 High Street
Hampton, NH 03842

Portsmouth

603.436.7171

330 Borthwick Avenue Portsmouth, NH 03801

Request for Medical Records

For parents with children under the age of 18 years, who wish to obtain a copy of their child’s medical record, please print out and complete the Request for Medical Records form and return it to our office.

All patients over the age of  18 who are requesting their medical records must complete and sign the following form to release their records to them.

The Practice will supply a copy of a patient's medical records at the rate of $0.25 per side plus any charges for postage used if records are mailed.

Please allow 7 to 10 days for processing of your request.

It is suggested that you make a copy of the records sent to you in the event you require a copy in the future. There will be a charge for copying any further requests for records.

Thank you