Health Information Release Forms
- Release/Obtain your health information (PDF)
- Makes changes or additions to your health information (PDF)
- A non-BMC provider to send information to BMC (PDF)
- A list of individuals or organizations who have received your health information (PDF)
- To release and obtain x-rays, or other radiological images, contact the Radiology Department, Film Library at 617.414.4884. You will need to complete this form,
Authorization for Release of Protected Health Information (PHI) (PDF).
*Note: To view PDF forms, download the latest version of Adobe Acrobat Reader.
If you experience any difficulties downloading the forms, please contact 617.414.4201.