If you are a current or former patient, or the legal guardian of a former patient, and you would like photo copies of a Patient Medical Record, please print and complete this form:
On the form, please provide as much detail as you can regarding your request for records or request to disclose records to another entity. Please be sure the form is dated and that an individual, over the age of 18, witnesses your signature.
Use the contact information on the form to fax or mail the request to our Health Information Management Department. Please allow 7-10 business days for us to process your request.
Should you have any questions, please feel free to contact our Health Information Management Department at 518-584-3600.
We Are Here To HelpFour Winds Hospitals are committed to serving our patients. Please know that, We have implemented measures for the protection |
30 Crescent Avenue
Saratoga Springs, NY 12866
Phone: 518-584-3600
Toll-Free: 1-800-888-5448