Do you want to...

Your Medical Record

*Medical Records has moved to our West Campus located at 29 Northwest Boulevard in Nashua.  Our office hours are 8:00 a.m. - 4:30 p.m., Monday through Friday. We are closed on major holidays.

X-ray images still must be obtained through the Radiology Department at the hospital, 8 Prospect Street, Nashua.

At The Medical Center, we respect your privacy. 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, and a legible copy of your valid photo identification. If you pick up your medical record in person, a photo ID is sufficient. Also, 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."

You have three options to obtain copies of your medical records:

  1. 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.  There is a charge of $0.50 per page if you want records for your personal use.  If we mail the records to your healthcare provider, there is no charge. 
  2. Download the Authorization to Release form, which is also available in Spanish, and then mail it to us at the address below, or fax it to 577-5756.  
  3. 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.

There is NO charge if we send records directly to another healthcare provider. However, there is a charge for copies of medical records that you pick-up or are mailed directly to you. The fee, which is legislated by the State of NH, is $15.00 for 1-30 pages and $.50 per page over 30 pages. Consideration will be given to waive fees for patients in cases of financial hardship. Third party requestors, such as 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.

Please print the Authorization to Release Protected Health Information (Medical Records) form, also available in Spanish, complete it and mail to:

Correspondence Coordinator, Health Information Services
Southern New Hampshire Medical Center
29 Northwest Blvd.
Nashua, NH 03063

Or fax to: (603) 577-5756.

For more information, please call the Correspondence Coordinator at (603) 577-7506.

If you need billing information, please contact Patient Relations at 577-7800.

2014 © Copyright Southern New Hampshire Health System, 8 Prospect St., Nashua, NH 03060