Looking to get your medical records?

You may complete the release by filling out the form below or by downloading the PDF to the right.

  • Please be specific in what you’re requesting. (date(s) of service, procedures, admission, etc…)
  • It may take 5-10 business days to process, but usually is processed in lesser time.
  • ***Please be advised Community Memorial Hospital’s Retention Period is 10 years. Everything prior to that has been destroyed, with the exception of Pediatric records, these are still available for 21 years from the DOS ***
  • In cases of deceased patients, we need proper documentation that you are authorized to receive the patient’s medical records. Please include a HCP, POA, or Death Certificate naming you next of kin.
  • Records for ‘continuity of care’ (transferring primary care from one provider to another) are usually sent electronically to the Provider and are free of charge for the patient.

Please click below to download a PDF of the Medical Records Release Form.