Request Medical Records

To request medical records, an authorization form must be filled out completely and signed.

If requesting your records be sent to another person/facility, please provide their name, address, phone and fax numbers.

Depending on the size of the record, they may be faxed or a CD will be mailed. No copies will be made as we are a paperless office.

If you are requesting records to be sent out, you may mail or fax back the request to 845-279-5168. Most records are prepared and sent within ten working days.

You may choose and print the appropriate document below.


Records Release From NMS

Download and print this form to authorize Northern Medical Specialists to release your medical records. 

Records Release To NMS

Please download and print this form to authorize the release of your medical records to Northern Medical Specialists.