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:

• Release of Information Authorization (Spanish)
• Release of Information Authorization (Portuguese)
• Records for a deceased patient (English)
• Records for a deceased patient (Spanish)

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.

Patient Request to Amend Health Information (PDF)

Fax or mail form to:

Norwalk Hospital
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.

Thomas Ayoub, MD

Patricia Bam, Chair

George Bauer

Susan Beyman

Peter Campbell

Pablo D. Colon, III

Peter Cordeau, President (ex-officio)

Tom Dubin, Vice Chair

MaryGrace Gudis

Karen Gottlieb

Peter Herbert

Danielle Robinson, PhD

Amy Schafrann

Ervin Shames

Curtis (Corky) Stewart

Sarah Lesesne Tripodi

Susan G. Weinberger, Ed.D.

Michael L. Witherspoon

Leslie Lincoln, Chief Nursing Officer, Norwalk Hospital

Steven Rosenberg, Treasurer, Chief Financial Officer, Nuvance Health

Daryl Story, MD, President of Medical Staff, Norwalk Hospital

Brian Wyatt, Deputy General Counsel, Nuvance Health

Directors

Dominick Colabella
Len DiNardo, Vice Chair
Lisa A. Esneault, Chair
James Naughton
Jeet M. Sandhu, MD
Christian J. Trefz

Staff

Grace Linhard, Chief Development Officer
Carolyn McKenna, Secretary
Steven Rosenberg, Treasurer