Request Medical Records
The Medical Records department at The Dimock Center is dedicated to maintaining your medical records and keeping your health information private and secure within federal and state regulations.
Learn how you can request medical and behavioral health records below.
Request Records Online
Please follow the steps outlined in the link below to initiate your records request:
Request Records By Fax or Email
Complete the relevant authorization form below.
Medical record authorization forms: English | Spanish
Behavioral health record authorization forms: English | Spanish
Then, complete the following required fields to properly execute your request:
- Patient’s full name (including maiden name if applicable)
- Address and telephone number
- Date of birth
- Email address
- Date of service
- Requester* information where medical records are being sent
- Sign and date the completed authorization form
Then, fax the completed form to 617-442-4583 or email it to [email protected].
To request your eyecare prescription, please email your first name, last name, and date of birth to [email protected].
*The requester must be a patient, the patient’s guardian, or legal representative.
Request Records In Person
You may also request a copy in person at the address below. If you are requesting your medical records in person, please complete the relevant medical or behavioral health authorization form linked above, and bring your photo identification with you.
The Dimock Center will complete all record requests within 30 days. Copy fees may apply for medical records, except for patients and healthcare-related facilities.
