Patients who wish to receive a copy of their medical records must complete an
for the Disclosure of Protected Health Information Form and return the
completed form to:
Health Information Management
201 Highland Street,
Clinton, MA 01510
General Laws, the hospital must maintain a medical record on every patient who
receives care. The record itself belongs to the hospital, but patients do have
the right to access their own medical information. All health care providers at
Clinton Hospital use the same chart in the best interest of patient care.
Medical Record Requests
Medical records can be
sent to another facility with the patient's written consent. Such requests may
take up to two weeks to complete. Written requests for copies of medical records
for personal use will also be honored in compliance with Massachusetts General
Laws. A fee for copying will be charged.
Faxing Medical Information
To decrease the
likelihood of a fax being sent to an unintended recipient or an individual, we
do not fax medical information except in medical emergencies.
Forms (school, insurance or work)
need a form completed should complete their portion of the form and sign an
authorization for the release of information. Please let us know when the form
will be picked up or if it should be mailed. Please allow one week for the forms
to be processed.
Laws require that a medical report pertaining to any injury that appears to be
compensable under worker's compensation be furnished to the employee, employer
and insurer within 14 days of completion of examination. Please note, that if a
patient denies release of information, it may be necessary to adjust his/her
account to a self-pay status.
Please call Health Information Management at 978-368-3801 or 978-368-3839 or
e-mail with questions.