Nyu medical records request 2025

1. Click ‘Get Form’ to open the NYU Medical Records Request in our editor.
2. Begin by filling in your personal details, including your name, date of birth, telephone number, and address. Ensure all fields are completed accurately to avoid delays.
3. In the section for listing the provider/entity from which you are requesting records, refer to the provided chart and enter the relevant information.
4. If you wish to include sensitive information such as Alcohol/Drug Treatment or Mental Health Treatment, make sure to initial next to each applicable type under number one.
5. Select the purpose for releasing your information by checking the appropriate box. This helps clarify why you need access to your records.
6. Choose how you would like to receive your records by selecting from options like mail, pick up, or secure email. Fill in any additional required details.
7. Finally, review all entries for accuracy before signing and dating the form at the bottom. If someone else is signing on your behalf, provide their name and authority.

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