We are committed to keeping your Protected Health Information (PHI) private, and we adhere to Federal and State laws to respect your confidentiality. You do have the right to request a copy of your medical records. You may submit your request in writing using one of the following methods:
For electronic response, please click here for the Holy Family Hospital – Methuen form.
For electronic response, please click here for the Holy Family Hospital – Haverhill form.
In-person requests are accepted in Haverhill and Methuen Health Information Offices Monday through Friday, 9 a.m. to 4 p.m.
If you would like to submit your request via fax:
If you are a provider seeking medical records, please fax your request to 978-794-9303.
All other requesters seeking medical records, please fax your request to 978-659-6027.
If someone other than the patient is requesting the records, we require a signed authorization from the patient or their legal representative (with a copy of the court appointment).
There may be a charge for creating a copy of your records.
Please be sure to provide a valid government-issued picture ID such as a driver’s license, state issued identification card or passport.
Click below to download the form:
English – Methuen, MA
Spanish – Methuen, MA
