You can request a copy of your medical records from Southcoast by downloading the authorization form.

Medical records are maintained by the Health Information Management departments for all three Southcoast sites — Charlton Memorial Hospital, St. Luke's Hospital and Tobey Hospital.

Our office hours are Monday through Friday from 8 a.m. to 4 p.m.

To obtain a copy of your medical record:

1. Download the Medical Records Authorization Form (Adobe Acrobat PDF file, 70KB)
   English

   Portuguese

   Spanish

   
   

2. Print and complete the authorization form to release medical records.

3. Mail or fax the fully completed form to the address below:
   Southcoast Hospitals Group
   Health Information Management
   200 Mill Road, Suite 210
   Fairhaven, MA 02719

   Fax: 508-973-3694

   Patients Phone: 508-973-3733

   Providers Phone: 508-973-3700

   E-mail: info@southcoast.org

Important: Include your name, address, home phone number, an alternate phone number (such as a cell or work phone) and e-mail address in case we need to contact you.

ID Required: When picking up copies of your records at the hospital, a photo ID is required.

Please allow at least three business days after receipt of your fully completed form for most routine medical record requests to be fulfilled. Urgent requests should be made by phone. Fees may apply for copies of some medical records.