If you would like a copy of your discharge summary or medical record, please print and complete this form

If you are under the age of 18, the form must be signed by a legal guardian. Please fax form to 518-580-1514 or mail the request to

Four Winds Hospital
30 Crescent Avenue
Saratoga Springs, NY 12866
Attn: Health Information Management Department

Please allow 7-10 business days for us to process your request. Any questions contact our Health Information Management Department at 518-584-3600.

2012 Benches in Courtyard 2 (1)