Medical Records Requests

Patients who wish to receive a copy of their medical records may submit a Release of Information Form and return the completed form to:

Wing Memorial Hospital
Health Information Management
40 Wright Street, Palmer, MA 01069

To ensure that we have the information to process requests quickly, please include:

  • Patient's name
  • Date of birth
  • Purpose for the request
  • Which records are being requested
  • Name and address of where records are to be sent
  • Dates of service needed

For more information, please contact the correspondence coordinator in Health Information Management at 413-284-5391 by e-mail.

Additional Information
By Massachusetts 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 Wing Memorial Hospital and Medical Centers 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)
Patients who 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.  

Workers' Compensation
Massachusetts General 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.