Patient Forms

Request a Copy of Your Medical Record

• If you would like us to request a copy of your medical record for yourself or a referring physician, you must complete authorization online. To do this, please visit the following website to complete the authorization form online. 
• If you have Connect patient portal, please login and request your records directly through the portal. If you have not signed up for the patient portal, please check the Connect Patient Portal page for instructions. If you need additional information, please call us at 212-305-8255.

Authorization for Release of Health Information

If you would like us to release any of your health information to another party, you must fill out a written authorization. To do this, you must complete authorization online, please visit the following website to complete the authorization form online. If you need additional information, please call us at 212-305-8255.