Medical Records folder with a Stethoscope

All requests for records or forms must go through our Medical Records Department. We require up to 7 business days to complete a request for a copy of your medical records. In order to fulfil your request there are certain forms that need to be completed.

A medical record request for personal use requires that you complete a “Request to Inspect and/or Receive a Copy of Personal Information” form.

Medical record requests that are sent to an outside agency require that you complete an “Authorization for Release of Protected Health Information” form.

Request for Forms Completion (physical, camp, school forms)
We require up to 10 business days to complete the form from the date it is dropped off. You or your family member must be an active patient of the health center. Forms will be sent to your provider the same day it is received.

You will have to complete an “Authorization for Release of Protected Health Information” form if your form request is for an outside agency.

You will receive a courtesy call when your form is completed and ready for pick up.

Medical Records Department

415 Columbia Road
Medical Records moved to the Top Floor
Dorchester, MA 02125



Monday –Thursday: 8:00 am – 5:00 pm
Friday: 9:45 am – 5:00 pm