To request a copy of your medical records, you must do so in writing.
Coastal Orthopedics requires patients to fill out the “Authorization for Release of Medical Records” form.
Please use the link below to print and complete the Authorization for Release of Medical Records form. Your form can then be returned by US mail or emailed, faxed to Valerie in our Medical Records department.
Return by Email: VLeone@CoastalOrthopaedics.com
Return by Fax: Fax it back to our secure fax line (203) 847-1940
Return by Mail:
Attn: Valerie, Medical Records
761 Main Ave., Suite 115
Norwalk, CT 06851
Please allow 5-7 business days to accommodate your request.
If you have any additional questions, please email VLeone@CoastalOrthopaedics.com .
Coastal Orthopedics may charge a reasonable fee not to exceed .65 cents a page for copying a patient’s record, and will charge the costs of materials for copying x-rays.
Patients can pick up copies of their medical record from our Norwalk Office between 8:30am and 4:30pm, Monday through Friday. Front Desk Staff is required to ask and view a drivers license that matches the name on the records release form. If someone other than the patient is picking up medical records, a signed release is required.