Medical Records
Serving Western Orange and Sullivan Counties, NY,
Northern Sussex County, NJ, and Pike County, PA.
Medical Records Request Form (PDF) (Microsoft Word)
The Health Information Management Department (HIM)
The Health Information Management Department is responsible for organization, storage and retrieval of all patient medical records. Birth certificates are completed for all newborns at Bon Secours Community Hospital by our birth registrar.
You may call our correspondence secretary at 845-858-7090, Monday through Friday from 8 a.m. to 4 p.m., or fax an authorization to 845-858-7408 for copies of your records. You will be required to sign an authorization before the records will be released. Identification is required. If the records are for your own use, there is a charge of $0.75 a page.
If you are writing or faxing an authorization, please send it to the attention of HIM Correspondence Secretary and include the following information:
- Name
- Date of birth
- Phone Number
- Date(s) of service
- Where copies are to be sent (name, phone, address)
- Reason for copies
- When copies are needed
- Your signature is required
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