1. Download the appropriate form(s) above
2. Complete the form(s) and send or fax to:
Mailing Address:
Hartford Hospital
Health Information Management
80 Seymour Street
P.O. Box 5037
Hartford, CT 06102
Patient & Healthcare Requests Fax:
860.545.6764
Legal, Ins, 3rd Party, Disability, IOL Requests Fax:
860.545.2328
Requests are processed on a first come, first served basis. Information is mailed to patients -- or patients can chose to pick it up at Hartford Hospital, Bliss Building, Room B104, First Floor. (Patients will get a phone call when the copies are ready for pick up.)