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The Health Information Management Services (HIMS) department processes requests for copies of Concord Hospital medical records. Copies will be mailed or they may be picked up at Concord Hospital’s main building at 250 Pleasant Street from Monday through Friday between 8:00 am and 4:30 pm. Staff members are also available to assist you by telephone at (603) 228-7312 or e-mail at release.info@crhc.org.

Our Pledge Regarding Your Health Information

Concord Hospital is committed to protecting the privacy of your health information. To learn how we may use or disclose your health information and your rights related to your health information, we invite you to read our Notice of Privacy Practices. The notice is also available at hospital and medical office registration locations and upon request.

Your request for copies of medical records for your own use or for disclosure to health care providers, insurance companies, attorneys, or other third parties must be made in writing to us. Please complete the Concord Hospital Authorization To Disclose Protected Health Information form.

Concord Hospital utilizes an electronic medical record (EMR) to capture medical information. This system allows pertinent medical information to be shared among your healthcare providers, including your primary care providers, providers that provide on-call services after hours, consultants, emergency department medical staff at Concord Hospital, as well as other departments within Concord Hospital. You do not need to complete the authorization form for these providers to access the health information in your EMR related to medical treatment.

There may be a fee for the copies we provide to you or to others you have requested we send the copies to. State law regulates our fees. We will inform you of the fees prior to completing your request.

We prioritize by type of request. Our first priority is the requests that are necessary for providing your immediate medical care. We have staff on call for emergency requests. For all other requests, it usually takes between five to 15 working days for us to provide the information requested. We will work with you if you have special deadlines.

For Your Own Records
  • Complete your full name and date of birth;
  • Complete “I authorize Concord Hospital;"
  • Complete “Send/Disclose” information to;
  • Your name, address and phone # or you may pick up the records at the hospital;
  • Check the “purpose” as “Personal records;"
  • Complete the “type of info. requested;"
  • Complete “Dates of care to be released." (You may not request future dates.);
  • Certain types of sensitive information may be specifically excluded by initialing the type;
  • Complete the authorization expiration date if different than six months from signature date;
  • Sign and date the form.
 For Another Person or Organization
  • Complete your full name and date of birth;
  • Complete “I authorize Concord Hospital;"
  • Complete “Send/Disclose” information to the person or organization’s name, address and phone # to send the records to;
  • Complete the “purpose;"
  • Complete the “type of info. requested;"
  • Complete “Dates of care to be released." (You may not request future dates.);
  • Certain types of sensitive information may be specifically excluded by initialing the type;
  • Complete the authorization expiration date if different than six months from signature date;
  • Sign and date the form.

Frequently Asked Questions about Requesting Copies of Medical Records

Do you provide copies of birth certificates?

No. The Concord City Clerk's Office provides certified copies of birth records to immediate family members for births that occurred in Concord, NH prior to 1989, as well as for births that occurred in any city or town in the State of New Hampshire after 1988.

I am an adoptee seeking information about my birth parents, who do I call for this information?

Call the New Hampshire Health and Human Services Department at (603) 271-4702.

What happens to my information after it is released?

You can ask the receiver of this information how it is used and stored.

How much information do you send for each request?

We limit the information sent to the minimum necessary for the purpose stated in the request. You may specify on the request form that specific information not be disclosed.

What happens to my information after it is released?

You can ask the receiver of this information how it is used and stored.

Can I obtain a copy of medical records other than my own?

Generally, you may not. There are some exceptions. You will need to provide written documentation to verify any of the exceptions:

  • If you have written authorization from the patient.
  • If you are the patient's legal guardian.
  • If you have been appointed by the patient as their legal representative.
  • If the patient is under 18 and you are the parent or legal guardian.

How can I obtain copies of my medical records related to services provided by my physician at his/her office?

Please call the physician office and ask about their process for releasing your medical records. If the practice is owned by Concord Hospital, you will be able to use the Concord Hospital Authorization form to request records.

Contact

Ph: (603) 228-7312