About our Process
To retrieve Medical Records, the form below must be completed and returned by fax, email, or dropped off at your Health Center. Please note that Medical Records may take up to 10 business to process.
Forms
If you are requesting Medical Records and you are the patient, patient representative, or third party, please use the authorization form below.
Authorization Form – English
Authorization Form – Spanish
Instructions – How to Complete the Form
Once the authorization form is completed, please submit it either by fax, email or drop it off at your health center.
Medical Records Department Information
Fax: 516-396-7511 | Email: HHLI-MedicalRecords@harmonyhealthcareli.org
If you have any questions or concerns, please contact our Medical Records Department at 516-396-7513.