Medical Records Requests

Patients have the right to review or receive copies of their medical records upon request. To obtain a copy of your medical records you may choose one of the following two methods:

MyChart Patient Portal

• South Shore Health MyChart Patient Portal 

South Shore Health Medical Record Release Forms 

South Shore Hospital

• English: Use or Disclose Protected Health Information
• Portuguese: Autorização de uso ou Divulgação Informações de Saúde Protegidas
• Spanish: Autorización del uso o Divulgación de Información Medica Protegida

South Shore Medical Center

• English: Use or Disclose Protected Health Information 
• Portuguese: Autorização de uso ou Divulgação Informações de Saúde Protegidas
• Spanish: Autorización del uso o Divulgación de Información Medica Protegida

South Shore VNA

• English: Use or Disclose Protected Health Information

The form must be properly filled out by the patient or patient’s guardian/legal representative with appropriate signature and date as well as legal Representative documentation if applicable.

South Shore Health requires specific consent for the following to be released, please be sure to initial items in each appropriate category in section 5 of the Authorization form: Alcohol and Drug Abuse, Mental Health, HIV/AIDS/Results/Treatment, Sexually Transmitted Diseases, Communication with a licensed Social Worker, Sexual Assault Victim’s Counseling, Genetic testing, Domestic Violence Victim’s Counseling, and Abortion.

Submit your completed medical records release form:

By mail:

South Shore Hospital / South Shore Medical Center / Women’s Center of South Shore Medical Center/ South Shore Urology
South Shore Health Business Office
Attn: Release of Information
PO Box 9147
Norwell, MA 02061

South Shore VNA South Shore Home Care Division
Attn: Health Information Management
30 Reservoir Park Drive
Rockland, MA 02370

By Fax:

South Shore Hospital / South Shore Medical Center / Women’s Center of South Shore Medical Center/South Shore Urology
(781) 878-5044

South Shore VNA
(781) 792-4206

By E-Mail:

releaseofinformation [at] southshorehealth.org (releaseofinformation[at]southshorehealth[dot]org)
NOTE: Fees may be associated with certain types of requests if applicable. To pay your balance, please use our Release of Information Payment Portal.

South Shore Women’s Health Records
South Shore Health is the legal keeper of records for the former South Shore Women’s Health.
To request your South Shore Women’s Health records, please submit a signed Use or Disclose Protected Health Information Form and submit it to the South Shore Health Release of Information department using the contact information listed above.

Health Express Records
To obtain your records from Health Express, please contact the Health Express location where you were seen.
LINK to Health Express Locations

Radiology/Diagnostic Images
Authorization to Release Radiology Diagnostic Images/Reports form 
Contact Information: Tel:(781) 624-8906; Fax:(781) 624-3356 Email: PDLDIFilmLibrary [at] southshorehealth.org (PDLDIFilmLibrary[at]southshorehealth[dot]org)

Breast Imaging Request
Authorization to Release Radiology Diagnostic Images/Reports form 
Contact Information: Tel:(781) 624-4584; Fax:(781) 542-8971 Email: PDLDIFilmLibrary [at] southshorehealth.org (PDLDIFilmLibrary[at]southshorehealth[dot]org)

If you have questions regarding your medical records, please contact:

South Shore Hospital/ South Shore Medical Center / Women’s Center of South Shore Medical Center/ South Shore Urology
Tel: (781) 624-8235

South Shore VNA
Tel: (781) 624-7070

Amendment of Protected Health Information Request Form 
Please print out the form single-sided and mail to South Shore Health Business office at the address listed above. Please contact the Data Integrity Team at: (781) 624-8714 with questions.