Request Your Medical Records
Our Release of Information staff will be happy to assist you with requests for your medical records. We also assist providers with completing forms for patients.
We can assist you with the following —
- access to your medical records
- obtaining copies of your medical records
- requests to amend your medical records
- completion of forms for benefits, insurance, and other reasons
The Release of Information Staff is expert in our patients' rights and their medical records.
The Release of Information Office is located in Building 200, Room B1-7F. Call 631-261-4400 x2631.
How to Request Information
To request a medical record, please select one of the forms from the right column, enter the requested information, sign the form and mail it to the following address:
VA Medical Center Northport
79 Middleville Road
Release of Information
Building 200, Room B1-7F
Northport, New York 11768
Because forms must contain an original signature, e-mailed forms cannot be accepted.
Requests for records will take approximately 10-14 days to process.
Fees
There is no cost to send copies directly to another health care provider. If copies are for a patient's personal use, photocopying fees may be assessed.
