Your Medical Records
In order to obtain copies of your medical records, please complete the Authorization to Disclose Health Information form and return the completed and signed form to:
HIM Department / Waterbury Hospital
64 Robbins Street, Waterbury, CT 06708
If you have any questions please call Health Information Management (HIM) at 203-573-6175.
Online Patient Record Request
We now have an online tool for the following individuals to request patient records:
- Patients requesting their own records
- Parents of minor patients requesting records
- Caregivers acting on behalf of a patient (i.e. Power of Attorney)
The Online tool verifies your identity by asking for a photo of your driver's license, which can be taken via webcam or smartphone. There is no additional charge to use this service.
Please note, Chrome, Safari and Firefox are the recommended browsers for this application. If you encounter any issues with your electronic request, please call our Health Information Management (HIM) at 203-573-6175.