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Medical Records

Requesting a Copy of Your Records

A copy of your medical records may be obtained by downloading and printing the form below and bringing it to your doctor's office, Butler Hospital's medical records office in the basement level of the Center House Building or by mail.

In many circumstances an original authorization is required. For additional information about access to medical records, please call (401) 455-6321

Please note, questions and requests for medical records should never be submitted via email.

Medical Records Release Form

To request your records by mail, send the completed form to:

Health Information Management
Butler Hospital
345 Blackstone Boulevard
Providence, RI 02906