If you would like us to forward a copy of your medical record to a health care provider, we need your written authorization, which is valid for six months. If you pick up your medical record in person a photo ID is required.
Please provide a range of dates of service, or information that identifies the information you need - for example, "all records from 2000 to present date" or "anything pertaining to my broken leg."
- For a paper copy of your records there is a charge of $0.14 per page (price set by guidelines issued by The U.S. Department of Health and Human Services Office of Civil Rights).
- For an electronic copy of your records there is a flat fee of $6.50 (price set by guidelines issued by The U.S. Department of Health and Human Services Office of Civil Rights). Electronic copies of records are provided to you on an encrypted CD-ROM disc.
- If we send your records directly to your healthcare provider there is no charge.
- Third party requests, from insurance companies and attorneys, are also charged for copies. You will receive your records from The Medical Center or Bactes Imaging Solutions. Payments for copies can be made by cash or check only.
Primary & Specialty Care Practices - Medical Records
Southern New Hampshire Medical Center - Medical Records
X-ray images still must be obtained through the Radiology Department at the hospital, 8 Prospect Street, Nashua.
You have three options to obtain copies of your medical records:
- Stop by our office and fill out an Authorization to Release form. We are located 29 Northwest Boulevard at the Medical Center's West Campus in Nashua. You will need a photo ID.
- Download Southern New Hampshire Medical Center Authorization to Release form, which is also available in Spanish, and then mail it to us at the address below, or fax it to (603) 577-5756.
- You can visit the Cashier window at the Main Campus, 8 Prospect St., and fill out the Authorization to Release form. They will forward it to us and you will be contacted.
Correspondence Coordinator, Health Information Services
Southern New Hampshire Medical Center
29 Northwest Blvd.
Nashua, NH 03063
For more information, please call the Correspondence Coordinator at (603) 577-7506.
If you need billing information, please contact Patient Billing at (603) 577-7800.