Medical Records

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

English – Haverhill, MA
Spanish – Haverhill, MA