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Medical Records

Medical Records

Medical Records

Frequently Asked Questions

Most requests for records will be processed in about a week. Older medical records are kept off site and may require extra time to retrieve the records. If you have additional questions please contact Medical Records at 860-445-3054 or 860-439-6022.

No there is no charge for your records.

Release of Information Form

    (check all that apply)
  • The confidentiality of this record is required under Chapter 899 P.L. 93-579 of the Connecticut General Statutes as well as Title 42 of the United States Code. This material should not be transmitted to anyone without the client’s written consent or authorization as provided for in these Statutes
  • • I understand that the medical record to be released may contain information pertaining to psychiatric, drug, and/or alcohol abuse diagnosis and treatment, and may also contain confidential HIV (AIDS) related information. A general authorization for the release of medical or other information is NOT sufficient for this purpose.
  • • I understand that under applicable law the information disclosed under this authorization may be subject to further disclosure by the client and thus may no longer be protected by federal privacy regulations.
  • • I understand that I may inspect or copy the information to be used or disclosed.
  • • I understand that my current treatment or continued treatment by Stonington Institute is in no way conditioned on whether or not I sign this authorization and that I may refuse to sign it.
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Questions? Please call 860-445-3054 or 860-439-6022 and ask for the Health Information Department.