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Additional Forms and Details
If copies of your records are going directly to a physician or hospital, there is no charge. If copies are being sent directly to you, there is a fee of 12 cents per page. An additional form is required to obtain records for a deceased patient.
Please find below additional forms:
Requesting an amendment to your medical record(s)
If you identify that information in your medical record is incorrect, please submit a completed request to amend health information form. Include your current address and phone number.
Fax or mail form to:
Health Information Services Department
34 Maple Street, Norwalk, CT 06850
Fax: (203) 899-5300
Contact the Norwalk Hospital Medical Record Department at (203) 852-2320 Monday through Friday 8 am - 4 pm.
Giving at Norwalk HospitalNorwalk Hospital relies on community support to continue our tradition of delivering dedicated patient care, research and community outreach in the region. We offer many ways to give and all gifts, no matter the size, are tax-deductible.
Price Transparency and Cost estimator toolsNuvance Health hospitals offer easy-to-access cost estimator tools for certain hospital items and services. These price lists comply with new federal government regulations aimed at increasing healthcare transparency for consumers. We know understanding medical bills can be difficult. We're here to help. Learn more about our cost estimator tools
- Emergency Department: Work closely with the Emergency Department leadership and staff to provide support services to staff, patients and their families.
- Music Therapy: Volunteers trained in the clinical use of music to accomplish individualized goals such as reducing stress, improving mood and self-expression.
- Volunteer Transport: Assist staff and families in various departments to help transport patients throughout clinical areas of the hospital. Transport volunteers may also wheel discharged patients from their rooms to patient pickup areas.
- Gift Shop: Greet and assist customers and staff within our gift shop. Our gift shop volunteers also work with staff to help keep the store maintained and organized. Volunteers also perform point of sale transactions, while providing excellent customer service.
- Patient Care Areas: Assist a variety of departments with delivering kind, compassionate care to our patients, guests and staff.
- Clerical Support: Assist office staff across several departments within the hospital.. These volunteers help staff with clerical duties including filing, copying and faxing, answering phones, data entry, and greeting visitors.
- Art and Hospitality Cart: Our hospitality and art cart volunteers are vital in bringing genuine joy to our patients. Volunteers assist by bringing art supplies and projects to patients within different departments.
- Goldstone Caregiver Coach: Caregiver Coaches work to provide support to the caregivers of patients throughout the hospital and encourage them to engage in self-care, with the goal of reducing caregiver stress. Our Caregiver Coaches are compassionate, empathetic and self-reflective individuals who are comfortable with providing support to caregivers in need. While personal and/or professional caregiving experience has been helpful in enhancing the empathy of those who become Caregiver Coaches, it is not a requirement.
- Patient to Patient, Family to Family Emotional Support Volunteer: Peer-to-peer supporters are people who have “been there.” They are empathetic and compassionate, working with those who have similar life circumstances to their own. Although the experience of one person can never be exactly the same experience as another, having someone to relate to can be incredibly supportive and reassuring. A peer-to-peer supporter, using the appropriate skills, can help an individual navigate their health journey from a physical, emotional and spiritual perspective.
- Pet Therapy: This program welcomes volunteers whose dogs are qualified with an approved organization (Good Dog Foundation, Therapy Dogs International and Pet Partners) to engage with patients and staff throughout the hospital. Volunteers must be 18 years or older to participate and able to commit to at least three visits per month.
How to Become a Volunteer
- A two-step PPD Skin Test (completed at your PCP or for free at Employee Health Services within Norwalk Hospital); or may provide proof of negative Quantiferon blood test within 30 days of starting.
- Proof of MMR (Measles, Mumps, and Rubella) immunity, in the form of two vaccines or a positive blood titer test.
- Proof of Varicella (chicken pox) immunity in the form of two vaccines or a positive blood titer test. We also accept two doses of the Shingles vaccine in lieu of Varicella vaccination.
- Annual Influenza Vaccine Proof
- Documentation of COVID-19 Vaccination and booster(s). Must be double vaccinated and boosted.
- Health Assessment signed by physician, proving that the volunteer is free and clear of communicable disease.
- Compliance clearance, fulfilled through completion of forms and attestations
- Interview with the Manager of Volunteer Resources and Volunteer Coordinator
- Reference checks
- Criminal background check
- Attendance at a mandatory training/orientation
Please contact Courtney Brown, Volunteer Coordinator at Norwalk Hospital at Courtney.Brown@nuvancehealth.org or (203) 852-2023 to learn more.
Norwalk Hospital Board of Directors
Amy Ahasic, MD
Thomas Ayoub, MD
Pablo D. Colon, III, Vice Chair
Peter R. Cordeau, President (ex-officio)
James N. Dimonekas
Leonard M. DiNardo
Thomas I.H. Dubin, Chair
Danielle Robinson, PhD
Susan G. Weinberger, Ed.D.
Michael L. Witherspoon
Leslie Lincoln, Chief Nursing Officer, Norwalk Hospital
Dan DeBarba, Treasurer, Chief Financial Officer, Nuvance Health
Carolyn McKenna, Secretary, Chief Legal Officer & General Counsel
Daryl Story, MD, President of Medical Staff, Norwalk Hospital
Brian Wyatt, Deputy General Counsel, Nuvance Health
Norwalk Hospital Foundation, Inc. Board of DirectorsDirectors
Lisa A. Esneault, Chair
Joshua Weinshank, Esq., Vice Chair
G. Blane Withers
Grace Linhard, Chief Development Officer
Carolyn McKenna, Secretary
Dan DeBarba, Treasurer