Request Medical Records
Essen Health Care takes Protecting the confidentiality of every patient’s medical record seriously. As a patient, you have the right to access your medical records.
How to Obtain a Copy of Your Medical Records.
Alternatively, you can request a copy of your medical records from the Office of Medical Records. Please follow the instructions below and complete the Authorization to Release Medical Records Form to help us process your request. Please note, a written request needs to be provided prior to processing. We are providing this downloadable form for your convenience.
Medical Records | Contact Information
2626 Halperin Avenue, 2nd Floor
Bronx, New York 10461
ATTN: Medical Records/Corporate Compliance Office
How to Get a Copy of Your Record from Medical Records.
CLICK HERE to print out a HIPAA Release of Information form (Verbal requests are not accepted).
All sections of the form must be completed in order for medical records to be released.
Print clearly, designate whether you require the entire record or a specific portion, and include the mailing address to which the records are to be sent (either your address or the address of your physician).
Submit Form Upload and email your completed signed form here or fax to: 646-461-2305. Please include the best way to contact you should we have any questions about your request.
FOR HEALTHCARE PROVIDERS
Physician office or hospital can request records during office hours by faxing a request on letterhead to 646-461-2305 or email from a company email address. Please include the patient’s name, DOB, and designate entire record or specific portion(s).
COVID-19 TEST RESULTS, PLEASE CALL 718-583-7736
FOR 3rd PARTY REQUESTS
Any third-party requestors should submit a request for patient records by following the process above with the legally required documentation