Medical Records

Medical Records

The Health Information Management Department is dedicated to maintaining your medical records and keeping your health information private and secure in accordance with patient rights and federal and state regulations.

For additional information regarding health records and privacy, please click here for the Notice of Health Information Privacy Practices.

We offer patients several options to access their health information.  

  •  SolutionHealth MyChart, is our patient portal which provides access to your health information summary.  Enroll in MyChart
  • Send us a completed, signed and dated Authorization to Release Protected Health Information form by mail to receive copies of records.
    Download form

    Send to: 

Elliot Health System Medical Records Department
One Elliot Way
Manchester, NH 03103.

You may also fax your form to 603-663-1856.

To request that the form be faxed or mailed to you, please call 603-663-2341.

Frequently Asked Questions

Per regulatory guidelines, Medical Records has up to 30 days to fulfill a request.

Please be aware that there is as reasonable cost-based fee for copying PHI in accordance with the State of NH statues. However, Elliot Health System does not currently charge patients for this service.

Elliot Health System does not maintain birth or death certificates. Certificates can be obtained from the Manchester City Clerk’s Office at 603-624-6455 or the State of New Hampshire Vital Records Department at 603-271-4650.

If you have specially protected health information in your chart (HIV, drug and alcohol, mental health, or genetic) please make sure you initial in the appropriate area of the form if you would like this information released.

Requests should be sent from your insurance company, attorney, or Disability Determination Service (DDS) and mailed to the address on the authorization form. All charges for medical records will be billed to the requestor and in accordance with the State of New Hampshire Statutes.

Patient requests for amendment/correction of protected health information should be made in writing by completing the Amendment/Correction form and submitting it to the Health Information Management Department at One Elliot Way, Manchester, NH or by faxing it to 603-663-1856.

Please contact the Radiology Department directly to facilitate your request 603-663-2541.

Please contact the Billing Department directly to facilitate your request 603-663-4977.

We are happy to assist you if you have additional questions. Please contact us during our hours of operation: Monday through Friday, 7:30 a.m. to 4 p.m. at 603-663-2341.

For additional information regarding health records and privacy, please click here for the Notice of Health Information Privacy Practices.

Contact Us

Elliot Health System
Health Information Management Department
One Elliot Way
Manchester, NH 03103

Fax: 603-663-1856