Medical Records

Medical Requests

The CHH Health Information Management Department maintains and safeguards the confidentiality of medical record information in accordance with the patient’s right to privacy, legal requirements and appropriate ethical considerations. The medical record and its contents are the property of the Charlotte Hungerford Hospital, however, patients and/or their authorized representative are entitled receive copies of the information contained within the medical record.

How do I obtain a copy of my medical record?
HIPAA requires a properly completed and signed authorization release be given to the Health Information Management Department by the patient in order for the Hospital to release medical records.

The Medical Records form is available online (below) or can be obtained by visiting the Health Information Management Department during normal business hours. Depending on the purpose of the request there may be a fee associated with the copy costs. The Medical Records department can contact you to pick up your records with a valid photo ID or the records can be mailed to you.

This form should be brought to the hospital’s Health Information Management Department (First Floor), faxed to 860.496.6633 or mailed to:

Charlotte Hungerford Hospital
Health Information Management Department
540 Litchfield Street
Torrington, CT 06790

Download HIPAA Medical Records Release

For more information, please call 860.496.6655.

How do I obtain a copy of my birth certificate?
Birth Certificates of people born at Charlotte Hungerford Hospital are filed and maintained at the Torrington Town Hall. To obtain a copy, contact the Town of Torrington City Clerk’s Office at 860.489.2236.

How do I obtain a copy of my radiology (X-ray) films?
HIPAA requires a properly completed and signed authorization release of medical records be given to the Radiology Department by the patient in order for the Hospital to release medical radiology records.

The form is available online (below) or can be obtained by visiting the Radiology Department during normal business hours. Depending on the purpose of the request there may be a fee associated with the copy costs. The Department requires a 24 hour notice to process the request, and a valid photo identification is require for pick-up.

This form should be brought to the hospital’s Radiology Department (First Floor),
fax to the Department at 860.482.2514, or mailed to:

Charlotte Hungerford Hospital
Radiology Department
540 Litchfield Street
Torrington, CT 06790

Download HIPAA Radiology Medical Records Release

For more information, please call 860.496.6541.

Medical Records (Health Information Management)