If you are requesting a copy of your medical record from a Lahey Health facility, pursuant to HIPAA 45 CFR, 164.524, we reserve the right to charge a reasonable cost-based fee for producing and mailing the copies. The rate will increase proportionately based on the size of your record and how you want your copy delivered. At no time will the cost-based fees exceed Massachusetts law (MGL Chapter 111; Section 70).
To process requests for medical records, Lahey Hospital & Medical Center needs either a signed form or letter. Either will suffice as a request for medical records.
- Download and complete the Authorization For Release of Medical Information form.
- Send a signed letter with the following information:
- Date of Birth
- Telephone Number
- Lahey Clinic Number (if known)
- Purpose of the Request
- Type of Information Requested
- Where to Send the Medical Record
Send completed form or signed letter to:
Lahey Hospital & Medical Center
41 Mall Road
Burlington, MA 01805
You may also request your records in person. Visit the Medical Records Office in the Gordon Building, First Floor, 29 Mall Road, Burlington, MA. The Gordon Building is located two buildings down from the main campus at 41 Mall Road. See map for exact building location.
Please note that any mail being sent to the Medical Records Office should be addressed to the main campus at 41 Mall Road.